A 57-year-old male patient with a history of benign prostatic hyperplasia, cirrhosis
of the liver, and hypertension presented to the Emergency Department (ED) with the
chief complaint of urinary urgency and passing blood and blood clots for 2 days. The
patient denied other symptoms, including fever, nausea, vomiting, diarrhea, abdominal
pain, chest pain, or back pain. He had no previous diagnosis of tuberculosis (TB),
however, he was at increased risk due to his proximity to the United States–Mexico
border, where TB is endemic. Physical examination was unremarkable, and urinalysis
was significant for large blood, white blood cell count of three to five cells per
high power field, red blood cell count of > 200 cells per high power field, negative
bacteria, with a negative culture. A noncontrast computed tomography scan revealed
an atrophic right kidney and dilated calyces containing calcifications consistent
with a diagnosis of putty kidney. Additional confirmatory studies were completed as
an outpatient, demonstrating a positive purified protein derivative test and urine
culture. Initial treatment included a four-drug regime over 2 months followed by a
two-drug regime for 6 additional months. The outcome of the patient's treatment was
not disclosed.
Keywords
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References
- Remember the "putty kidney"–a reminder of days gone by.Urology. 2020; 141: e18-e19
- Classics in abdominal imaging: the putty kidney.Abdom Radiol (NY). 2017; 43: 1510-1512
Visweswaran RK, Pais VM Jr, Dionne-Odom J. Urogenital tuberculosis. In: UpToDate: 2022. Available at: https://www.uptodate.com/contents/urogenital-tuberculosis. Accessed April 20, 2022.
- Completely calcified non-functioning kidney: a classical image of putty kidney.BMJ Case Rep. 2014 Aug 12; 2014bcr2013203030
- Renal tuberculosis.Radiographics. 2004; 24: 251-256
- Extrapulmonary tuberculosis: an overview.Am Fam Physician. 2005; 72: 1761-1768
- Medical treatment for urogenital tuberculosis (UGTB).GMS Infect Dis. 2018 Aug 9; 6 (Doc04)https://doi.org/10.3205/id000039
Article info
Publication history
Published online: September 13, 2022
Accepted:
September 4,
2022
Received in revised form:
August 20,
2022
Received:
May 19,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
