Case Report on renal tuberculosis-can it be diagnosed early?

Tuberculosis of the genitourinary tract is one of the late reactivation or complications of pulmonary tuberculosis which is mostly prevalent in young adults and middle-aged people. We here report a case of Renal Tuberculosis presented to us with recurrent urinary tract infection with sterile pyuria suspected to have Renal TB at the end of 6 months.Her urine for AFB culture and biopsy turned out to be positive and was put on AntiTB treatment.We had to subject patient for Right sided nephrectomy due to extensive renal involvement.Patient was given CAT-II Anti TB traetment as she had consumed CAT-I in 1996 for Pulmonary Tuberculosis and was declared cured at end of 8 months.But after one and a half year patient had involvement of left kidney along with Left ureter and bladder and needed to be subjected for augmentation cystoplasty with ureteric reimplantation.AntiTB treatment was restarted.Patients urine sample and biopsy were sensitive to first line drugs. The diagnosis of this case was delayed because of the general impression that renal tuberculosis is rare.A high index of clinical suspicion at all times with combined investigative tools espescially CT urography andAFB culture permits accurate diagnosis and prompt treatment of most cases and prevents them from being complicated.