KIDNEY TB

PRESENTER:G.SIVA PRASAD, PG XIII.MODERATOR:DR.E.KRISHNA MURTHY, MD(HOMOEO).

KIDNEY TBDEFINITION: Acute or chronic infection caused by mycobacterium tuberculosis called tuberculosis, if it infect kidney called TB kidney or Renal tuberculosis.

TUBERCULOSIS-CHARECTERSTICS:

It is lifelong infection Tuberculosis is chronic specific granulomatous inflammation of caseous type Formation of tubercleType IV hypersensitivity reaction

MYCOBACTERIUM TUBERCULOSIS-SPECIFIC FEATURES:1.Aeorobic bacteria2.Non motile3.Acid fast (due to presence of fatty acid component of wall of bacilli)4.Gram positive5.Rod shaped bacteria(size- 4 microns)6.No spores, no capsule7. Produce niacin,INH Sensitive, catalase positive8.chemical fraction: EPIDIMIALOGY:

Renal TB: It is commonest extra pulmonary site,

common in young adults,

more common in low socio economic status people,

common in male (male:female=2:1)

MODE OF INFECTION( ROUTE OF INFECTION):From primary lesion through different routes tuberculosis effect kidneyFrom lung(primary lesion) through haematogenous route it effect kidneyFrom potts spine through direct spread it effect kidneyFrom prostate,fallopian tube through ascending infection reach kidney.

PATHOGEN ESIS: Renal tuberculosis is unilateral, more effect right kidney,Stage1: Tuberculosis bacilli settled in cortexStage2:caseous foci form( granuloma)Stage3.coalesce of foci ( Big lesion formedStage4.process extend to medulla and papilla ulcerate into pelvis and spread to other part of kidney, to bladder,prostate and pelvic viscera.

PATHOLOGY:

Renal tuberculosis present as following conditions1.Acute military renal tuberculosis2.chronic renal tuberculosis (tubercular pyelonephritis, tubercular pyelitis)3.closed renal tuberculosis4.tubercular pyelonephritis5.tubercular hydronephrosis

Kidney-TBSPREAD:

Submucosa of renal pelvis is first involved, than spread through natural passages it enter into ureter( golf hole meatus), bladder (systolic bladder)Other kidney,prostate, seminal vesicles, epididymis.

CLINICAL FEATURES:

-haematuria-pus in urine-renal colic-frequency of urination-dysuria-General symptoms of tuberculosis( fever, wight loss, night sweats)-lumbar discomfort

INVESTIGATIONS:-urine analysis-urine culture and sensitivity-cystoscopy-renal profile-investigation about primary lesionTREATMENT:

Renal TB has good prognosis if diagnosed early. But in advanced stages, renal dysfunction occur causing renal failure. The patients should be advance good diet and all the general measures advised for TB.Anti tubercular treatmentTreat according to end results(CRF)

HOMOEOPATHIC: According to Murphy clinical repertoryKidney-tuberculosis- Ars Iod, Calc Iod, China Ars. Bac, calc, hecla, kali iod, kreosote

BIBILIOGRAPHY:

1.Text book of pathology, HARSHAMOHAN2. Text book of pathology, DEY AND DEY3.Text book of medicine, DAVIDSON