Urogenital tuberculosis in immunocompromised patients

Area of Science:

• Urology
• Infectious Diseases
• Radiology

Background:

• Urogenital tuberculosis (UGT) is a significant global health concern.
• Understanding variations in UGT presentation is crucial for timely diagnosis and treatment.
• Immunocompromised states, such as acquired immunodeficiency syndrome (AIDS) and post-transplant immunosuppression, can alter disease manifestations.

Purpose of the Study:

• To compare the clinicoradiological presentation of urogenital tuberculosis (UGT) between immunocompromised and non-immunocompromised patients.
• To identify key differences in symptoms, organ involvement, and outcomes.

Main Methods:

• Retrospective analysis of 80 patients diagnosed with UGT.
• Division into two groups: 8 immunocompromised (4 with AIDS, 4 renal transplant recipients) and 72 non-immunocompromised patients.
• Comparison of age, clinical signs, diagnostic methods, urogenital involvement patterns, and early mortality.

Main Results:

• Immunocompromised patients presented with more fever (87.5% vs. 43.1%) and less storage symptoms (37.5% vs. 76.4%).
• Shorter disease duration (<6 months: 87.5% vs. 2.8%) and higher rates of disseminated tuberculosis (62.5% vs. 18.1%) were observed in the immunocompromised group.
• Predominantly parenchymal renal involvement (87.5% vs. 6.2%) was more frequent in immunocompromised patients, with less collecting system stenosis (12.5% vs. 93.8%) and contracted bladder (12.5% vs. 65.3%).

Conclusions:

• UGT exhibits distinct clinicoradiological features in immunocompromised individuals, characterized by systemic symptoms and disseminated disease.
• Parenchymal renal lesions are more common, while collecting system involvement is less frequent in immunocompromised patients with UGT.
• In immunosuppressed patients, UGT mimics a severe bacterial infection with potential bacteremia and visceral metastatic foci.