Paraspinal sinuses? Do remember renal tuberculosis

Approximately 4%-8% of patients with pulmonary tuberculosis develop clinically significant genitourinary infection. In the case being reported, a 30-year-old female, admitted with right-sided back swelling, local pain and low-grade fever. The swelling gradually increased in size over a period of 6 months and had burst spontaneously forming a pus discharging with associated localised pain and fever bringing the patient to the hospital. X-ray lumbar spine, chest and kidney ureter bladder showed no abnormalities. Ultrasound findings were suggestive of pyonephrosis with a posterior paraspinal abscess with a sinus tract within the posterior paraspinal region. CT findings were more conclusive in suggesting the sinus tract origin. Finding of tuberculous kidney and upper ureteric stricture with sinus tract opening in the posterior paraspinal region was made on CT. Right nephrectomy was done. Histopathologically proved it to be tuberculous kidney.