Genitourinary tuberculosis: a 12-year experience
Abstract number: P585
Staios D., Skolarikos A., Fakiri E.M., Alevizatos G., Ntrivala M.A., Deliveliotis C., Papafrangas E.
Background: We present our experience with genitouritary tuberculosis (GUTB).
Methods: We reviewed the medical records of patients who have been treated for GUTB. The epidemiology, clinical presentation, diagnosis, treatment and long-term follow-up are presented.
Results: 27 males and 8 females were treated for GUTB in our hospital. 19 patients were admitted for pulmonary infection, 10 patients for upper tract dilation and LUTS, 4 patients for fever of unknown origin, one patient with painful testicle and one patient for haematuria. Urine culture in liquid media (Mycobacteria Growth Indicator Tube; MGlT) was positive in 27 patients at a mean time of 12.1 days, while culture in solid media (Lowenstein-Jensen medium; LJ) was positive in 23 patients at a mean time of 26 days. Acid-fast stain (Ziehl-Neelsen; ZN) was positive in only 9 patients raising the positive predictive value (PPV) of MGIT, LJ and ZN in 90%, 63% and 25%, respectively. Mono-resistance was noted in 4 isolates (isoniazid, streptomycin, pyrazinamide), poly-resistance in 2 isolates (isoniazid/streptomycin; isoniazid/pyrazinamide/ethambutol) and multi-resistance in one isolate.
Urological intervention (14 double-J stents; 2 nephrostomy tube, 1 nephrectomy) was needed in 17 patients at presentation. All patients were treated for a period of 9 months with the exception of one patient who was treated for 12 months. The mean follow-up was 44.3 months (range 5146). During follow-up two patients died because of sepsis secondary to urinary tract manipulation. No other complication was noted and the urinary tract system was normal in 24 patients at the last evaluation.
Conclusions: GUTB has a wide spectrum of clinical and radiological findings. A high clinical suspicion is warranted for diagnosis. MGlT shows the highest PPV among the diagnostic studies. The incidence of mono-resistance or multi-resistance to first-line anti-tuberculosis agents still remains relatively low. Complications secondary to the infection or its treatment are rare and most of the patients are cured following appropriate treatment.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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