Chronic pyelonephritis as a mimics of kidney tuberculosis

Background. The most common reason for late diagnosis of urogenital tuberculosis (UGTB) is low alertness of doctors; the second most common reason is the nature of the course of the disease, the absence of pathognomonic signs, the tendency to be mimics of other diseases.

Description of the clinical case. Patient E., 50 years old, complained of pain in the lumbar region and hypogastrium, periodic increases in body temperature to 37.5 ˚С, frequent urination, constant urine output through the vagina. Epidemiological history is burdened. The onset of the disease was at the age of 25, after which the patient repeatedly took courses of antibacterial treatment with little effect. Tuberculosis (TB) was diagnosed only at the age of 50, when kidney function ceased, cicatricial microcystis and vesicovaginal fistula formed.

Conclusion. The given example demonstrates errors in diagnosis. The long-term, recurrent nature of the inflammatory process against the background of repeated courses of antimicrobial therapy, aggravated contact with tuberculosis should have alerted the doctor to UGTB. Progressive decrease in bladder capacity also indicated a specific inflammation. A single negative PCR test for MBT is not a criterion for excluding TB. A decrease in the number of patients with kidney TB does not mean the disappearance of TB in this localization, but only indicates the difficulty of recognizing this disease.