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Journal SINTA 1

Renal Tuberculosis: The Masquerader

ACTA MEDICA INDONESIANA · Vol. 51 No. 4 (2020)

ISSN
2338-2732, 0125-9326
Published
2020-02-10
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Tuberculosis (TB) remains a worldwide scourge and the most common cause of mortality from infectious disease. Around 95% of cases occur in developing country. Renal TB is a rare cases that complicates 3-4% of pulmonary TB patients and commonly overlooked in clinical practice due to its symptoms may mimic other diseases.A-39-year-old man was admitted to our institution due to flank pain. He had history of low grade fever and oligouria since 5 months prior. He had no complaint of cough, dyspnea, or night sweat. He was a non smoker and had no past medical history of tuberculosis. Previous 4 months abdominal ultrasound showed left pelvocaliectasis and ureteral dilatation with suspicion of left ureteral stenosis. Ureterolithiasis could not be excluded. No prostate enlargement or vesicolithiasis was seen. Intravenous pyelography (IVP) examination demonstrated similar finding. Initial laboratory blood examination showed anemia (10.7 g/dl), leukocytosis (14,080/ul), increased in serum creatinin (4.2 mg/dl), ureum (227 mg/dl), and calcium (6.78 mg/dl). Serology examinations were negative for HIV, HBsAg, anti HCV and blood culture had no growth. Urinary examination revealed severe leucocyturia, hematuria, and negative for bacteria, nitrite and cast. Urine culture was positive for Candida glabrata. Pulmonary X-ray suggested right pleural fibrotic. He was initially diagnosed as multiple myeloma with fungal infection. Nevertheless, additional peripheral blood smear showed neither rouleaux formation nor blast. He underwent percutaneous nephrostomy and got micafungin intravenously. Instead of improving, the patient deteriorated and transferred to intensive room. We then explored the possibility of TB infection. Further examination revealed positive for Mycobacterium tuberculosis in urinary polymerase chain reaction (PCR) test. Tracheal sputum examination was positive for acid fast bacilli staining. There was low level of serum vitamin D2 (5.8 ng/ml). He got TB treatment with rifampicin, isoniazid, pyrazinamide, and ethambutol. Unfortunately, the patient eventually succumbed.

Keywords

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Co-authorOrganisationJoint articles
Laniyati HamijoyoAffiliation unknown5
Trinugroho Heri FadjariAffiliation unknown2
Fauliza RakhimaAffiliation unknown2
Rubin Surachno GondodiputroAffiliation unknown2
Irsan HasanAffiliation unknown1
Indra WijayaAffiliation unknown1
R.N. Yasmin KusumawardhaniAffiliation unknown1
Bachti AlisjahbanaAffiliation unknown1
Budi SetiabudiawanAffiliation unknown1
Januar Wibawa MarthaAffiliation unknown1
Syarief HidayatAffiliation unknown1
Mohammad Rizki AkbarAffiliation unknown1
Henny TantonoAffiliation unknown1
Sylvie SakasasmitaAffiliation unknown1
Kevin KarimAffiliation unknown1
Sasfia CandrianitaAffiliation unknown1
Erica Kwan YueAffiliation unknown1
Aang SetiawanAffiliation unknown1
Amaylia OehadianAffiliation unknown1
Ria BandiaraAffiliation unknown1
Lisda AmaliaAffiliation unknown1
Hikmat PermanaAffiliation unknown1
Ervita RitongaAffiliation unknown1
Maya KusumawatiAffiliation unknown1
Miftahurachman MiftahurachmanAffiliation unknown1
Nanny Natalia SoetedjoAffiliation unknown1
Samadhi Tulus MakmudAffiliation unknown1
Nur SamsuAffiliation unknown1
Atma GunawanAffiliation unknown1
Mohammad RudiansyahAffiliation unknown1
Enita Rakhmawati KurniaatmajaAffiliation unknown1
Ria BandariaAffiliation unknown1
Djallalluddin DjallalluddinAffiliation unknown1
Nuvita HasriantiAffiliation unknown1
Etik MertiantiAffiliation unknown1
Alif Noeriyanto RahmanAffiliation unknown1
Anwar Samhari bin Mat ArshadAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">Renal Tuberculosis: The Masquerader</dc:title>
	<dc:creator>Supriyadi, Rudi</dc:creator>
	<dc:creator>Darmawan, Guntur</dc:creator>
	<dc:creator>Pranggono, Emmy Hermiyanti</dc:creator>
	<dc:subject xml:lang="en-US">renal</dc:subject>
	<dc:subject xml:lang="en-US">tuberculosis</dc:subject>
	<dc:subject xml:lang="en-US">pulmonary TB</dc:subject>
	<dc:description xml:lang="en-US">Tuberculosis (TB) remains a worldwide scourge and the most common cause of mortality from infectious disease. Around 95% of cases occur in developing country. Renal TB is a rare cases that complicates 3-4% of pulmonary TB patients and commonly overlooked in clinical practice due to its symptoms may mimic other diseases.A-39-year-old man was admitted to our institution due to flank pain. He had history of low grade fever and oligouria since 5 months prior. He had no complaint of cough, dyspnea, or night sweat. He was a non smoker and had no past medical history of tuberculosis. Previous 4 months abdominal ultrasound showed left pelvocaliectasis and ureteral dilatation with suspicion of left ureteral stenosis. Ureterolithiasis could not be excluded. No prostate enlargement or vesicolithiasis was seen. Intravenous pyelography (IVP) examination demonstrated similar finding. Initial laboratory blood examination showed anemia (10.7 g/dl), leukocytosis (14,080/ul), increased in serum creatinin (4.2 mg/dl), ureum (227 mg/dl), and calcium (6.78 mg/dl). Serology examinations were negative for HIV, HBsAg, anti HCV and blood culture had no growth. Urinary examination revealed severe leucocyturia, hematuria, and negative for bacteria, nitrite and cast. Urine culture was positive for Candida glabrata. Pulmonary X-ray suggested right pleural fibrotic. He was initially diagnosed as multiple myeloma with fungal infection. Nevertheless, additional peripheral blood smear showed neither rouleaux formation nor blast. He underwent percutaneous nephrostomy and got micafungin intravenously. Instead of improving, the patient deteriorated and transferred to intensive room. We then explored the possibility of TB infection. Further examination revealed positive for Mycobacterium tuberculosis in urinary polymerase chain reaction (PCR) test. Tracheal sputum examination was positive for acid fast bacilli staining. There was low level of serum vitamin D2 (5.8 ng/ml). He got TB treatment with rifampicin, isoniazid, pyrazinamide, and ethambutol. Unfortunately, the patient eventually succumbed.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2020-02-10</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/826</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 51 No. 4 (2019): Acta Medica Indonesiana; 353</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/826/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2020 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>