The ubiquitous distribution of urinary droplets within most households may be worthy of consideration when a family member is discharging acid fast bacilli in his urine. Children of parents with genitourinary tuberculosis may indeed manifest skin test conversion under these circumstances. As a distinct clinical entity, genitourinary tuberculosis in the pediatric age group is not commonly seen. (In the 25 yr between 1946 and 1971 only 30 patients with tuberculosis of the urinary tract were seen in the author's hospital.) It does have a place, however, in pediatric urologic differential diagnosis although the symptoms, if any, are often nonspecific, for instance, mild dysuria or frequency, and the intravenous pyelograms may show normal kidneys. Positive urine cultures for acid fast bacilli have been seen in children with bone, miliary, and epididymal tuberculosis as well as tuberculous meningitis. It is unfortunate, however, if renal lesions are undetected because of a low index of suspicion in children with a positive purified protein derivative or other clinical evidences of pulmonary tuberculosis, when one considers the seriousness of this disease which tends to invade and destroy both kidneys if unsuspected and untreated. The symptoms and clinical findings may be subtle but the potential for marked and rapid renal deterioration is quite obvious. Assiduous bacteriologic testing for genitourinary tuberculosis, followed by specific triple drug chemotherapy for 2 yr, based on drug susceptibility test findings, provides the most effective means of halting this formerly deadly disease.
|Original language||English (US)|
|Number of pages||4|
|Journal||New York State Journal of Medicine|
|State||Published - Dec 1 1973|
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