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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We are reporting on a decade of experinece with cases of renal tuberculosis treated at a large tuberculosis hospital. Most patients were men less than 50 years old. The most frequent symptoms were dysuria, back or flank pain, nocturia and hematuria. Physical examinations were generally normal and hypertension was not seen. Most patients had acid urinary pH, pyuria and/or hematuria. Excretory urograms were abnormal in 86 per cent of the cases, the most common finding being preserved function but calicectasis or abscess. Most patients had abnormal chest x-rays and nearly half of them had coexisting, active pulmonary or miliary tuberculosis. Tuberculin tests were positive in 85 per cent of the cases. In our experience urinary tuberculosis was almost always responsive to multi-drug chemotherapy, even in patients with a non-functioning, tuberculous kidney. An asymptomatic, non-functioning kidney need not be removed, provided documentation of urine culture conversion is obtained and a prolonged period of multi-drug chemotherapy is completed.
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PMID:Urinary tuberculosis: a review of 44 cases treated since 1963. 127 40

We evaluated 83 cases of genito-urinary tuberculosis retrospectively. Flank pain and non-specific urinary complaints were the major symptoms. Although some authors prefer short-term medical therapy, the relapse rate in our series with six-month therapy was 22%, and we therefore suggest a therapy period of at least 12 months is necessary. The poor nutritional status and social conditions characteristic of subjects from our region may, however, be a factor in this high relapse rate.
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PMID:Genito-urinary tuberculosis: a review of 83 cases. 210 54

A series of 24 patients with renal angiomyolipoma was reviewed. Their ages ranged from 10 to 70 years (average 41). Four cases were associated with tuberous sclerosis, 1 with spinal neurilemmoma, 1 with transitional cell carcinoma and another with renal tuberculosis. The presenting symptoms in decreasing frequencies were flank pain, mass, haematuria, fever, syncope and respiratory distress. Although it has often been said that angiomyolipomas associated with tuberous sclerosis are small and asymptomatic, all 4 such patients in this study had large symptomatic tumours. Before the advent of CT scan and ultrasonography, the pre-operative diagnostic rate for cases unassociated with tuberous sclerosis was 10% (1/10). With the combined use of these 2 modalities, the diagnostic rate increased to 60% (6/10). Most patients in this series were treated with nephrectomy. However, equally good outcomes occurred in 2 patients who received partial nephrectomies. Pre-operative diagnosis now makes it possible to consider more conservative management.
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PMID:Renal angiomyolipoma: report of 24 cases. 226 29

Tuberculous splenic abscesses do virtually not occur in immunocompetent patients. Tuberculous abscesses have been reported only from areas, where the prevalence of both HIV infection and tuberculosis is very high such as Central Africa. In our institution two of seven patients with AIDS and disseminated tuberculosis who were treated during the year 1994 developed tuberculous splenic abscesses. Both patients were resident in Central Europe and had fever and weight loss prior to admission. Multiple hypoechoic lesions up to 1.5 cm in diameter developed in the spleen of both patients on day 11 and 16 after admission, respectively. Initially no symptoms related to the splenic involvement and no leucocytosis were seen in both patients. One patient developed leucocytosis and left sided flank pain caused by a subtotal splenic abscess because the diagnosis and therapy of tuberculosis was delayed. Both patients responded promptly to triple drug antituberculous therapy without surgical intervention. We conclude that also in European patients multiple hypoechoic/hypodense lesions in the spleen of HIV positive patients are highly suggestive of disseminated tuberculosis. Follow-up by ultrasound may help to establish the correct diagnosis and may further prevent unnecessary complications in these patients.
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PMID:Splenic abscesses and abdominal tuberculosis in patients with AIDS. 879 44

The incidence of tuberculosis has risen in many parts of the world, and more attention is being focused on genitourinary tuberculosis (GT), the second most common extrathoracic form of tuberculosis. Although chemotherapy is the mainstay of treatment, ablative surgery as a first-line management may be unavoidable for sepsis or abscesses. In cases with hydronephrosis and progressive renal insufficiency caused by obstruction, renal drainage (by stenting or nephrostomy) must be performed immediately. In all other situations triple-drug chemotherapy should be undertaken for at least 6 months and stable conversion obtained before ablative or reconstructive surgery is planned. Nephrectomy or partial nephrectomy is indicated for nonfunctioning or poorly functioning kidneys, particularly if continuous flank pain or hypertension is present. Stenosis of the ureter usually can be managed by temporary stenting and adjuvant corticosteroid therapy. Today the indications for augmentation are rare, but bladder replacement may be combined with ureter replacement using segments of intestine.
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PMID:Indications for surgical management of genitourinary tuberculosis. 920 38

We report the case of a 27-year-old Asian man who self-medicated with two capsules of rifampin 1 year after completing a continuous course of chemotherapy for tuberculosis that included that drug. He developed flank pain and edema and presented with uremia requiring dialysis; despite this, he had a serum potassium of only 3.5 mEq/L. Renal biopsy showed interstitial infiltrate with inflammation of the tubules. Renal function began to improve after a 3-week course of prednisone. This case is remarkable for the severity of the renal failure despite such a minimal self-exposure.
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PMID:Tubulointerstitial nephritis associated with minimal self reexposure to rifampin. 1021 65

In 174 cases of genitourinary tuberculosis diagnosed and treated in our clinic we evaluated, retrospectively, age and sex distributions, symptoms, physical and laboratory findings, primary focus, surgical and medical treatments. Flank pain and non-specific urinary complaints, e.g. dysuria, were the major symptoms. Although some authors prefer short-term medical therapy for the treatment of genitourinary tuberculosis, the relapse rate in our series after 12 months of therapy was 19% and we therefore suggest that therapy should be continued for at least 12 months. The poor nutritional status and social conditions characteristic of subjects from our region may, however, have influenced this high relapse rate.
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PMID:Genitourinary tuberculosis: a review of 174 cases. 1206 15

This report describes a 56-year old woman with an unusual form of chronic pyelonephritis mimicking tuberculosis on histopathological findings. She visited our hospital complaining of left flank pain. Left staghorn calculus and retroperitoneal abscess extending from the kidney were demonstrated on CT. No bacteria, including mycobacteria were identified in preoperative urine bacterial culture. Left nephrectomy with drainage of retroperitoneal abscess was performed. Microscopically, the nephrectomy specimen showed caseating granulomas, formed by epitheloid cells, highly suggestive renal tuberculosis. In spite of these findings, acid-fast bacteria were not revealed in the renal lesion nor the abscess, and cultures of the abscess for mycobacteria were also negative. Because of failure of identifying Mycobacterium tuberculosis, this case should be diagnosed as not renal tuberculosis, but pseudotuberculous pyelonehritis, which has been mentioned in recent literatures. Although this disease is not widely recognized, we must be aware of it to avoid unnecessary antituberculous therapy.
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PMID:[Pseudotuberculous pyelonephritis associated with staghorn calculus: a case report]. 1263 3

Renal mucormyosis is a rare entity and normally diagnosed at postmortem. Isolated cases diagnosed antemortem are even rarer and only a few cases have been reported. The disease is associated with a high mortality rate, especially in patients with underlying disease. Clinical presentation is non-specific and includes flank pain, fever and pyuria with or without haematuria. Identifying fungal hyphae microscopically is essential for diagnosis. We present a rare isolated fatal case of renal mucormycosis in a 77-year-old man with chronic obstructive pulmonary disease (COPD) and old tuberculosis (TB) who had been diagnosed after a right nephrectomy. We believe early diagnosis and appropriate treatment for fungal infection, together with the predisposing underlying disease, is crucial for survival.
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PMID:Isolated fatal renal mucormycosis in a patient with chronic obstructive pulmonary disease and tuberculosis. 1471 98

A 50-year-old man presented with recurrent episodes of right flank pain and dysuria for many years. Abdominal radiograph and intravenous urography showed extensive right renal parenchymal calcification in a lobar distribution and a non-functioning right kidney, characteristic of end-stage tuberculosis. The pathology, clinical manifestations, and radiological findings of renal tuberculosis are discussed.
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PMID:Clinics in diagnostic imaging (97). Right renal tuberculous autonephrectomy. 1514 63


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