TB Research

A Child Presenting with Persistent Asymptomatic Microscopic Hematuria: a Case Report

Rama Naghshizadian

Journal of Pediatric Nephrology · 2019-11

Abstract

Tuberculosis (TB) is a serious and important infectious disease worldwide. Children commonly develop renal tuberculosis (TB) as a complication of primary pulmonary infection with Mycobacterium tuberculosis characterized by hilar lymphadenopathy often with lung opacity. Renal TB accounts for up to 27% of extra-pulmonary cases. The disease is more prevalent in children with immunodeficiency syndromes and the recipients of organ transplantations. The signs and symptoms of renal TB are non-specific and challenging. Most patients present with persistent non-glomerular microscopic hematuria without abdominal or flank pain. Some may have signs and symptoms of the lower urinary tract such as voiding dysfunction. A diagnosis of renal TB is suspected upon detecting pyuria in the absence of common bacterial infections and is confirmed by isolation of acid-fast lactobacillus in the urine or tissue biopsy. Anti-tuberculosis drugs most frequently used in the pediatric age group are a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol.Keywords: Non-glomerular hematuria; Renal tuberculosis; Diagnosis; Treatment; Child; Mycobacterium tuberculosis.

MeSH terms

  • Medicine
  • Ethambutol
  • Pyrazinamide
  • Tuberculosis
  • Pyuria
  • Rifampicin
  • Asymptomatic
  • Renal biopsy
  • Microscopic hematuria
  • Urinary system
  • Surgery
  • Internal medicine
  • Biopsy