Clinical Characteristics of Genitourinary Tuberculosis in Children

Ahn, Sang Seog; Lee, Sang Kon; Cho, Seong Hyun; Kim, Jong Yeon; Lee, Seong Ho; Kang, Ilmo

Abstract

PURPOSE: The incidence of renal tuberculosis has decreased considerably in recent years, but the disease still threatens public health. Childhood genitourinary tuberculosis (GUTB) has been very rare. The aim of the study was to analyze the clinical aspects and characteristics of childhood GUTB.
MATERIALS AND METHODS
A total of 145 cases of GUTB were diagnosed. We analyzed retrospectively the clinical manifestations of eight patients with GUTB younger than 15 years of age.
RESULTS
The age of the patients, six boys and two girls, ranged from 5 to 14 years. Follow up period ranged from 12 to 145 months. Presenting features were diverse and included gross hematuria in five cases. Rarer presenting features included one case of epididymorchitis. All had had BCG vaccination at around 1 month old. Conclusive diagnosis was made on the basis of isolation of mycobacterium tuberculosis in five patients, whereas three patients were given a therapeutic trial based on clinical manifestations. The most common site of involvement was the kidney (7 cases). Temporary urinary diversional procedures were performed in two patients for relieving ureteral obstruction. Excisional surgery was needed in three patients, whereas one underwent ureteroneocystostomy for ureteric stricture. Response to antitubercular drug therapy was gratifying. No relapse was observed during follow-up period.
CONCLUSIONS
Childhood GUTB is rare, but may become serious. The importance of early diagnosis is emphasized, and aggressive treatment is needed in advanced childhood tuberculosis for preservation of renal function.