Download Free Medical Tuberculosis of Urinary Tract PowerPoint Presentation

Tuberculosis of Urinary Tract PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Tuberculosis of the Urinary tract.

Tags : Tuberculosis, Urinary tract, mycobacteria strains, human tuberculous disease, M. tuberculosis, M. bovis, M. leprae and M. africanum. Mycobacteria tuberculosis accounts for most of the disease, Renal TB, Papillary necrosis, calyceal stem

Published on : Dec 29, 2020 | Views : 2501 | Downloads : 4

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Tuberculosis of Urinary tract
Slide 2-

5000 BC Observed in humans 375 BC Hippocrates described ‘phthisis’ 1696 Wiseman described ‘scrofula & King’s Evil’ 1882 Koch’s postulates organism in disease growth outwith body disease following infection History
Slide 3-

1882 Ehrlich discovered acid-fastness 1925 Calmette & Guerin generate BCG 1929 Medlar reported asymptomatic renal tubercles in pulmonary TB 1937 Wildbolz coined term ‘genitourinary tuberculosis’ 1943 Streptomicin discovered 1952 Isoniazid discovered 1966 Rifampicin discovered History………………..
Slide 4-

Peak incidence in 20-40 age group worldwide Male-female ratio 2:1 Virulence of mycobacterium strain Cord factor - inhibits granuloma formation Sulphatides - impairs macrophage phagocytosis Lipoarabinomannan – inhibits macrophage killing Host factors - immunocompromise Etiology
Slide 5-

Mycobacteria 2.4 um long x 0.5um wide Non-motile, non-flagellated Strict aerobes Thick cell wall containing 4 complex layers of approx 50% lipids Very difficult to stain (hot carbolfuschin) Stain is ‘fast’ to acid or alcohol Very slow growing – doubling time 16-20 hrs Microbiology
Slide 6-

4 mycobacteria strains cause human tuberculous disease M. tuberculosis M. bovis M. leprae M. africanum Mycobacteria tuberculosis accounts for most of the disease Humans are the only reservoir of the disease
Slide 7-

Pathogenesis
Slide 8-

Frequent painless micturition LUTS Sterile pyuria, 20% without pyuria Gross hematuria 10%, microscopic hematuria 50% Renal or suprapubic pain Clinical presentation
Slide 9-

Renal TB is caused by the activation of a prior blood borne renal infection Healing process results in fibrous tissue and calcium salts being deposited Papillary necrosis and strictures in the calyceal stem Renal TB
Slide 10-

KUB radiographic view in a patient with left renal tuberculosis with associated calcifications
Slide 11-

Tuberculous ureteritis is always an extension of the disease from the kidney Leads to fibrosis and stricture formation Site most commonly affected is the ureterovesical junction (UVJ) Ureter TB
Slide 12-

Stricture at the distal left ureter
Slide 13-

Earliest forms of infection start around one or another ureteral orifice Healed mucosal lesions have a stellate appearance Bladder TB
Slide 14-

Urine Examination Urine culture (3-5 specimen) Tuberculin Test Diagnosis
Slide 15-

Criteria for Tuberculin Positivity, by Risk Group
Slide 16-

Radiography Plain Radiographs Intravenous Urography Computed Tomography (gold standard tool ) Cystoscopy and Biopsy (rarely indicated ) Retrograde Pyelography stricture at the lower end of the ureter ureteral catheterization Percutaneous Antegrade Pyelography Arteriography, Radioisotope Investigation and MRI
Slide 17-

CT after oral contrast medium with bilateral tuberculosis
Slide 18-

Antitubercular drugs: Multidrug treatment 6 to 9 months ( Iseman, 2000 ) Rifampicin, INH, pyrazinamide, and ethambutol Management
Slide 19-

Surgery Current focus is on organ preservation and reconstruction Delayed until medical therapy has been administered for at least 4 to 6 weeks
Slide 20-

Nephrectomy Indications nonfunctioning kidney with or without calcification extensive disease involving the whole kidney, together with hypertension and UPJ obstruction coexisting renal carcinoma
Slide 21-

Partial Nephrectomy Localized polar lesion containing calcification that has failed to respond after 6 weeks of intensive chemotherapy Area of calcification slowly increasing in size and may gradually destroy the whole kidney
Slide 22-

Reconstructive Surgery Ureteral Strictures: entire stricture should be excised Augmentation Cystoplasty Urinary Conduit Diversion Orthotopic Neobladder