Genitourinary tuberculosis in children - a diagnostic challenge

Open access


Pediatricians frequently encounter hematuria in children. One of the tardy complication of pulmonary tuberculosis, which is most characteristic and common in teenagers and middle aged, is represented by genitourinary tuberculosis. Renal tuberculosis is rare during childhood. The authors present a series of cases where the presenting symptom was gross or microscopic persistent hematuria. The diagnosis of urogenital tuberculosis was established from early-morning urine culture in all cases. In a patient with symptoms of recurrent urinary tract infection or hematuria associated with sterile pyuria the suspicion of GUTB must be considered. A delayed diagnosis of renal tuberculosis led to kidney damage and sequels of GUTB, including renal failure. Our cases report emphasizes that in case of persistent hematuria GUTB may be considered as a differential diagnosis

1. European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2013.

Stockholm: European Centre for Disease Prevention and Control, 2013. (


3. Centers for Disease Control and Prevention, 2000 (

4. Figueiredo AA, Lucon AM, Junior RF, Srougi M. Epidemiology of urogenital tuberculosis worldwide. Int J Urol. 2008;15(9):827-32

5. Rai A, Pahwa H, Jain V, Misra S. Management of Genito-Urinary Tuberculosis. The Internet Journal of Surgery 2010;23(1). DOI: 10.5580/173a

6. Nerli RB, Kamat GV, Alur SB, Koura A, Vikram P, Amarkhed SS. Genitourinary tuberculosis in pediatric urological practice. J Pediatr Urol. 2008;4(4):299-303

7. Lenk S, Schroeder J. Genitourinary tuberculosis. Curr Opin Urol. 2001;11:93-8

8. Hopewell PC. A clinical view of tuberculosis. Radiol Clin North Am. 1995;33:641-53

9. Chattopadhyay A, Bhatnagar V, Agarwala S, Mitra DK. Genitourinary tuberculosis in pediatric surgical practice. J Ped Surg. 1997;32(9):1283-6

10. Carrol ED, Clark JE, Cant AJ. Non-pulmonary tuberculosis. Paediatr Respir Rev. 2001;2(2):113-9

11. Vasanthakumari R. Mycobacteria in Textbook of Microbiology BI Publications Pvt Ltd New Delhi 2007, 231-251

12. Sandin RL. Polymerase chain reaction and other amplification technique in mycobacteria. Clin Lab Med. 1996;16(3):617-39

13. WHO report 2012. Geneva: World Health Organization; 2012. Global tuberculosis report. (WHO/HTM/TB/2012.6)

14. Richeldi L: An update on the diagnosis of tuberculosis infection. Am J Respir Crit Care Med. 2006 Oct;174(7):736-42

15. Segall L, Covic A. Diagnosis of Tuberculosis in Dialysis Patients: Current Strategy. Clin J Am Soc Nephrol 2010 Jun;5(6):1114-22

16. Johnson WD, Johnson CW, Lowe FC: Tuberculosis and parasitic diseases of the genitourinary system. PC Walsh, AB Retik, ED Vaughan, AJ Wein (Eds.), Campbell's urology (8th ed.), Saunders,Philadelphia (2002), 743-763

17. Aaronson IA. Urogenital tuberculosis in children. S Afr Med J 1987;71(7):424-6

18. Ingelfinger JR, Davis AE, Grupe WE. Frequency and etiology of gross hematuria in a general pediatric setting. Pediatrics. 1977;59(4):557-61

19. Dhua AK, Borkar N, Ghosh V, Aggarwal SK. Renal tuberculosis in infancy. J Indian Assoc Pediatr Surg. 2011Apr;16(2):69-71

20. Dhandore P, Hombalkar NN, Vaze D. Nonhealing sinus on the back: A rare presentation of genitourinary tuberculosis. J Pediatr Urol. 2010 Aug;6(4):423-5

21. Andronikou S, Wieselthaler N. Modern imaging of tuberculosis in children: thoracic, central nervous system and abdominal tuberculosis. Pediatr Radiol. 2004; 34(11):861-75

22. Cremin BJ. Radiological imaging of urogenital TB in children with emphasis on ultrasound. Pediatr Radiol. 1987;17(1):34-8

23. Chiang LW, Jacobsen AS, Ong CL, Huang WS. Persistent sterile pyuria in children? Don’t forget tuberculosis! Singapore Med J. 2010;51(3):e48-50

24. Cek M., Lenk S, Naber KG, Bishop MC, Johansen TE, Botto H, Grabe M, Lobel B, Redorta JP, Tenke P. EAU Guidelines for the Management of Genitourinary Tuberculosis. Eur Urol. 2005;48(3):353-62

25. Kadhiravan T, Sharma SK. Medical management of genitourinary tuberculosis. Indian J Urol. 2008;24(3):362-8.

26. Figueiredo AA, Lucon AM. Urogenital Tuberculosis: Update and Review of 8961 cases from the World Literature. Rev Urol. 2008;10(3):207-17

27. Chiappini E, Fossi F, Bonsignori F, Sollai S, Galli L, de Martino M. Utility of interferon-γ release assay results to monitor anti-tubercular treatment in adults and children. Clin Ther. 2012 May;34(5):1041-8

Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

Journal Information

IMPACT FACTOR 2018: 0,800
5-year IMPACT FACTOR: 0,655

CiteScore 2017: 0.31

SCImago Journal Rank (SJR) 2018: 0.194
Source Normalized Impact per Paper (SNIP) 2018: 0.306


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 291 217 40
PDF Downloads 113 92 10