Rare Case of Obstructive Anuria Revealing Urinary Tuberculosis

Abdi El Mostapha*, Nedjim Abdelkerim Saleh, Al Afifi Mahmoud, Ait Mahanna Hamza, Nachid Abdella, Dakir Mohamed, Debbagh Adil and Aboutaieb Rachid

CHU Ibn Rochd, Casablanca, Morocco

^*Correspondance to: Abdi El Mostapha 

 PDF  Full Text DOI: 10.25107/2474-1647.3093

Abstract

The percentage of urogenital TB among extrapulmonary TB is 33.7% to 45.5%. According to the World Health Organization reports reviewed in March 2014, about one-third of the world?s population has latent Tuberculosis (TB). Obstructive anuria is defined as a stop total diuresis or an amount less than 400 ml/24 h, secondary to an obstacle located at any level of the upper excretory canal. Neoplastic etiologies are the most common causes. In rare cases urogenital tuberculosis causes obstructive anuria by bilateral ureteral stenosis. Mr. AM is 37 years old, with no particular pathological history. The patient has had bilateral low back pain for 5 years without hematuria. Admitted to the emergency room for bilateral low back pain with anuria. On examination, the blood pressure is 11/6 mmHg and the temperature is 37?C, anuric with diuresis below 200 cc/24 h, the urogenital examination finds bilateral lumbar sensitivity, absence of bladder globe Renal function is impaired: urea: 2.01 g L-1, creatinine: 77 mg L-1. Ultrasound revealed a major ureterohydronephrosis on the right, laminating the cortex and moderate left with an empty bladder. The urinary tree without preparation does not show an image of radiopaque lithiasis. We performed a bilateral percutaneous nephrostomy after failure of double J stent and cytobacteriological examination of urine for Mycobacterium tuberculosis (Mtb) confirmed the diagnosis. Anti-bacillary treatment was started. The evolution was marked by an improvement in creatinine and urea levels after nephrostomy. The main reasons for late diagnosis are a lack of alertness on UGTB among urologists, general practitioners and the nonspecific variable clinical features. Destructive forms of Kidney Tuberculosis (KTB) cannot be cured by chemotherapy, so surgery is necessary.

Keywords

Anuria; Diagnosis; Tuberculosis; Urogenital; Management

Cite the article

El Mostapha , Saleh NA, Mahmoud AA, Hamza AM, Abdella N, Mohamed D, et al. Rare Case of Obstructive Anuria Revealing Urinary Tuberculosis. Clin Surg. 2021; 6: 3093..