Abstract
Genitourinary tuberculosis usually occurs in young adults and the middle-aged and is very uncommon in the paediatric population. It generally presents with haematuria, pyuria, irritative voiding symptoms and flank pain; presentation as a renal mass is highly unusual. We report a two-year-old girl who was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 with abdominal pain. Subsequent radiological investigations revealed a left renal hypoechoic mass lesion. A left nephroureterectomy was performed on suspicion of a Wilms' tumour. Histopathology indicated an epithelioid granuloma with lymphocytic infiltration, suggestive of a tubercular aetiology. A Mantoux tuberculin skin test was positive; however, there was no evidence of tuberculosis detected elsewhere in the body and the source of the infection could not be identified. A diagnosis of renal tuberculosis was made and the child was treated with antitubercular drugs. The patient was asymptomatic at a six-month follow-up.
Highlights
Genitourinary tuberculosis usually occurs in young adults and the middle-aged and is very uncommon in the paediatric population
It generally presents with haematuria, pyuria, irritative voiding symptoms and flank pain; presentation as a renal mass is highly unusual
We report a two-year-old girl who was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 with abdominal pain
Summary
A two-year-old girl presented to a private health clinic in Kolkata, India, with non-specific abdominal pain of three months’ duration. The patient underwent further evaluations for congenital TB; Figure 2: Haematoxylin and eosin stain at x10 magnification showing a caseating epithelioid granuloma and lymphoid follicle within the perinephric fat of a two-year-old girl with renal tuberculosis. The patient was diagnosed with renal TB based on the findings of the renal histopathology and ancillary investigations She subsequently underwent two months of intensive phase antitubercular therapy with isoniazid, rifampicin, pyrazinamide and ethambutol, followed by four months of continuation phase therapy with isoniazid and rifampicin, as per the guidelines of the Revised National Tuberculosis Control Programme (RNTCP).[11] She improved symptomatically and the abdominal pain subsided within one month of beginning the treatment. At the time of writing, the patient was being followed up at regular intervals
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