Renal tuberculosis

The genitourinary tract is the second most common site for tuberculous infection after the lungs; almost always affects the kidneys during the primary exposure to infection but does not present clinically.

Tuberculosis of the kidneys usually spreads by a hematogenous route from pulmonary disease, although it occasionally may be secondary to tuberculosis of the GI tract or bone.

By the time of diagnosis of renal tuberculosis, the primary source of pulmonary infection may be inactive or calcified.

The initial renal focus is usually a small tubercle in the glandular and cortical arterioles. With the passage of time, these lesions progress to form necrotizing lesions.

Tertiary TB from kidneys:

• Ureteric involvement occurs as a descending infection secondary to kidney infection.

• Bladder tuberculous infection is almost always secondary to renal involvement.

• Tuberculosis of the seminal vesicles usually occurs as a result of hematogenous spread.

Male genital tuberculosis presents with epididymitis, hydrocele or a palpable testicular mass, and discharging scrotal or perineal sinuses.

Female genital tuberculosis presents with pelvic pain, menstrual irregularity, and sterility.

Category: Pathology Notes