October - LRS Institute of Tuberculosis & Respiratory Diseases
October - LRS Institute of Tuberculosis & Respiratory Diseases October - LRS Institute of Tuberculosis & Respiratory Diseases
238 P.K. MUKERJI, K.D. VERMA, S.K. AGARWAL AND R. PRASAD TABLE 3 Qualitative Analysis of Isotope Renograms of 16 Patients with Urine Culture Positive for M, tuberculosis Side Type of abnormality in renogram Abnormal Normal Type A Type B Type C (No.) (%) (No.) (%) Right 0 2 0 Left 2 9 0 13 81.2 3 18.8 TABLE 4 Analysis of Intravenous Pyelograms (I. V.P.) of J 6 Patients with Urine Culture Positive for M. tuberculosis I.V.P. Findings Site of Abnormality Total Right Kidney Left Kidney Both Kidneys No. % Normal pyelograms 9 56.3 Abnormal pyelograms 7 43.7 (a) Moth eaten appearance of calyces 1 3 0 4 57.1 (b) Calycectasis with poor visualization 0 1 0 1 14.3 (c) Calycectasis with hydro-ureter 0 1 0 1 14.3 (d) Non-visualisation 0 1 0 1 14.3 Out of 16 urine culture positive patients, 7 (43.7 %) patients had abnormal I.V.P. findings. The most common abnormality was ‘moth eaten’ appearance of calyces (57.1 %). However, no bilateral abnormality could be found in these patients. On correlation with I.V.P. findings and abnormalities in renograms, it was observed that all the seven cases who had abnormal findings I.V.P., also had abnormal renograms. However, among 9 cases with normal I.V.P., 6 patients (66.7%) showed abnormal renogram and all presented with “Type B” abnormality. It was observed that out of 16 patients with urine culture positive for M. tuberculosis, 3 Ind. J. Tub., Vol. XXIX, No. 4 patients (18.8%) had no abnormalities, while 4 patients (25%) had abnormality in isotope renograms only. In 7 patients (43.7%) all the parameters were abnormal. Discussion Positive urine cultures for Mycobacterium tuberculosis of 150 patients suffering from pulmonary (100 cases) and osteo-articular (50 cases) tuberculosis was found in 16 (10.7%) patients. This supports the concept that renal tuberculosis is the most common extra-pulmonary form of tuberculosis (Bentz et al 1975). In pulmonary group the yield of positive urine culture was 9 %. This findings is well in agreement with other workers (Hobbs, 1923;
A CORRELATIVE STUDY OF ISOTOPE RENOGRAPHY, INTRAVENOUS PYELOGRAPHY ETC. 239 TABLE 5 Correlation Between Intravenous Pyelogram (I. V.P.) and Isotope Renograms of 16 Urine Culture Positive Canes I.V.P. Findings Total No. Abnormal isotope Renograms Type of Abnormality (No.) (%} A B C Normal 9 6 66.7 0 6 0 Abnormal 7 7 100 2 5 0 (a) Moth eaten appearance of calyces 4 4 100 0 4 0 (b) Calyceulasis with pour visualization 1 1 100 1 0 0 (c) Culycectasis with hydro-ureter 1 1 100 0 1 0 (d) N on- visualization 1 1 100 1 0 0 I TABLE 6 Grouping of Urine Culture Positive Cases According to all the three parameters Groups Findings Urinary Symptoms I.V.P, Isotope Renogram No. Percent Urinalysis I A A A 7 43.7 II A N A 2 12-5 III N N A 4 25.0 IV N N N 3 18.8 Rosencranz, 1940 and Medlar, 1942). On the findings. Various investigators from time to other hand, the yield of positive urine culture time have emphasized that bacilluria due to for M. tuberculosis in osteo-articular group M. tuberculosis can exist without causing was 14%. Higher percentage of urine culture clinical manifestations (Cunningham, 1911; positivity in osteo-articular group has been Bernstein, 1914; Hobbs, 1923). These investireported (Harris. 1928; Mclell and Davis, 1942; gators also believed that bacilluria with M. Snellman 1950). tuberculosis could occur in the absence of renal lesions and was not necessarily a proof of On routine urinalysis, overall abnormality genito-urinary tuberculosis, in urine was present in 9 (56-2%) of 16 culture positive cases and 7 (43.8%) had normal To study the frequency to this occurrence, we urine analysis. Bentz et al (1975) reported performed isotope renography and intravenous that a total of 58% urine culture positive pyelography (I.V.P.) in these 16 patients with cases in their series were having normal urine tuberculous bacilluria. Isotope renography de- Ind. J. Tab., Vol. XXIX, No. 4
- Page 1 and 2: The Indian Journal of Tuberculosis
- Page 3 and 4: REVIEW ARTICLE Skeletal tuberculosi
- Page 5 and 6: TUBERCULOSIS OF SPINE 215 whether b
- Page 7 and 8: TUBERCULOSIS OF SPINE 217 it has es
- Page 9 and 10: TUBERCULOSIS OF SPINE 219 of parapl
- Page 11 and 12: TUBERCULOSIS OF SPINE 221 treatment
- Page 13 and 14: VISUAL PATTERN IN ETHAMBUTOL TREATE
- Page 15 and 16: VISUAL PATTERN IN ETHEMBUTOL TREATE
- Page 17 and 18: LIVER ENZYMES DURING TREATMENT WITH
- Page 19 and 20: LIVER ENZYMES DURING TREATMENT WITH
- Page 21 and 22: LIVER ENZYMES DURING TREATMENT WITH
- Page 23 and 24: GENITO-URINARY TUBERCULOSIS IN PULM
- Page 25 and 26: GENITRO-URINARY TUBERCULOSIS IN PUL
- Page 27: A CORRELATIVE STUDY ON ISOTOPE RENO
- Page 31 and 32: A CORRELATIVE STUDY OF ISOTOPE RENO
- Page 33 and 34: TUBERCULOSIS OF THE BREAST 243 whic
- Page 35 and 36: TUBERCULOUS OSTEOMYELITIS OF THE ST
- Page 37 and 38: TUBERCULOSIS OF THE OESOPHAGUS 247
- Page 39 and 40: GASTRIC TUBERCULOSIS ERODING SPLENI
- Page 41 and 42: NEWS AND NOTES 33RD TB SEAL CAMPAIG
238 P.K. MUKERJI, K.D. VERMA, S.K. AGARWAL AND R. PRASAD<br />
TABLE 3<br />
Qualitative Analysis <strong>of</strong> Isotope Renograms <strong>of</strong> 16 Patients with Urine Culture Positive for M, tuberculosis<br />
Side<br />
Type <strong>of</strong> abnormality<br />
in<br />
renogram Abnormal Normal<br />
Type A Type B Type C (No.) (%) (No.) (%)<br />
Right 0 2 0<br />
Left 2 9 0<br />
13 81.2 3 18.8<br />
TABLE 4<br />
Analysis <strong>of</strong> Intravenous Pyelograms (I. V.P.) <strong>of</strong> J 6 Patients with Urine Culture Positive for M. tuberculosis<br />
I.V.P. Findings<br />
Site <strong>of</strong> Abnormality<br />
Total<br />
Right<br />
Kidney<br />
Left<br />
Kidney<br />
Both<br />
Kidneys<br />
No. %<br />
Normal pyelograms 9 56.3<br />
Abnormal pyelograms 7 43.7<br />
(a) Moth eaten appearance <strong>of</strong> calyces 1 3 0 4 57.1<br />
(b) Calycectasis with poor visualization 0 1 0 1 14.3<br />
(c) Calycectasis with hydro-ureter 0 1 0 1 14.3<br />
(d) Non-visualisation 0 1 0 1 14.3<br />
Out <strong>of</strong> 16 urine culture positive patients,<br />
7 (43.7 %) patients had abnormal I.V.P. findings.<br />
The most common abnormality was ‘moth<br />
eaten’ appearance <strong>of</strong> calyces (57.1 %). However,<br />
no bilateral abnormality could be found in<br />
these patients.<br />
On correlation with I.V.P. findings and<br />
abnormalities in renograms, it was observed that<br />
all the seven cases who had abnormal findings<br />
I.V.P., also had abnormal renograms. However,<br />
among 9 cases with normal I.V.P., 6<br />
patients (66.7%) showed abnormal renogram<br />
and all presented with “Type B” abnormality.<br />
It was observed that out <strong>of</strong> 16 patients with<br />
urine culture positive for M. tuberculosis, 3<br />
Ind. J. Tub., Vol. XXIX, No. 4<br />
patients (18.8%) had no abnormalities, while<br />
4 patients (25%) had abnormality in isotope<br />
renograms only. In 7 patients (43.7%) all the<br />
parameters were abnormal.<br />
Discussion<br />
Positive urine cultures for Mycobacterium<br />
tuberculosis <strong>of</strong> 150 patients suffering from<br />
pulmonary (100 cases) and osteo-articular (50<br />
cases) tuberculosis was found in 16 (10.7%)<br />
patients. This supports the concept that renal<br />
tuberculosis is the most common extra-pulmonary<br />
form <strong>of</strong> tuberculosis (Bentz et al 1975).<br />
In pulmonary group the yield <strong>of</strong> positive urine<br />
culture was 9 %. This findings is well in agreement<br />
with other workers (Hobbs, 1923;
Change language