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Tuberculosis

TB of the kidney

07/12/2006

Question:

Can you get kidney TB and not have lung TB? Also, how do you get tested for kidney TB?

Answer:

Yes, you can have TB in the kidney and not have "active" TB disease of the lung. However, most people with TB disease of the kidney have had TB infection of the lung some time in the past. (But not active lung disease)

Most active TB disease occurs in the lungs but about 20% of TB disease is outside of the lungs, which can include the kidneys approximately 2% of the times. TB is spread from one person to another through the air. When a person inhales the TB germ, the bacteria can settle in the lung and begin to grow. From the lungs it can enter the blood stream and spread to other parts of the body including the kidneys. Usually, the body's immune system is able to fight the bacteria and stop it from growing in the lungs and other parts of the body. This is called Latent TB Infection. About 10% of people with latent TB infection can develop active TB disease sometime in their lifetime. Active TB can develop in any parts of the body that was initially infected.

Diagnosis of kidney tuberculosis can be difficult. Patients may not have symptoms of infection such as fever, chills, night sweats or weight loss. Some may have back or side pain, blood or infection in the urine. Most patients will have a positive tuberculin skin test and abnormal X-ray of the kidneys. Definitive diagnosis usually requires culturing or growing the Mycobacterium tuberculosis bacteria from the urine or kidney tissue. But sometimes it may not grow. Your doctor may need to refer you to a specialist for diagnosis and treatment of Kidney TB.

1. CDC, Reported Tuberculosis in the United States. www.cdc.gov/tb

2. CDC, Questions and Answers about TB 2005. www.cdc.gov/tb

3. Iseman M. Extrapulmonary Tuberculosis in Adults. In: A Clinician's Guide to Tuberculosis. LWW. 2000:161-162.

4. Goldfarb S, Saiman L, Tuberculosis of the Genitourinary Tract. In: Tuberculosis. Rom W and Garay editors. LWW.2004: 549 -563.

For more information:

Go to the Tuberculosis health topic, where you can:

Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University