rifampin and Tuberculosis--Renal

Genitourinary tuberculosis was diagnosed in 543 patients in Spanish hospital from 1978 through 2003. Of the 371 male 34 (9.2%) had orchiepididymitis. Mean age was 52.7 years and the presenting symptom was scrotal swelling and/or pain. Over 50% of cases involved the right ovotestis. Associated renal tuberculosis and active disease in extraurological organs presented in 64% and 19.2% of cases, respectively. Diagnosis was established by culture of Mycobacterium tuberculosis recovery from urine and/or purulent scrotal exudate. Genomic amplification techniques aided the diagnosis in 8 patients. Treatment was rifampin, isoniazide, and pyrazinamide or ethambutol. Eight patients required combined medical and surgical treatment.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Combined Modality Therapy; Comorbidity; Epididymitis; Ethambutol; Exudates and Transudates; HIV Infections; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Orchitis; Prostatitis; Pyrazinamide; Retrospective Studies; Ribotyping; Rifampin; RNA, Ribosomal, 16S; Scrotum; Spain; Tuberculosis, Male Genital; Tuberculosis, Renal; Urine

Renal transplant recipients are prone to a variety of infections due a persistent immunodepleted state. Incidence of tuberculosis in this population is much higher compared with the general population. While pulmonary tuberculosis still remains the commonest form in this population, renal allograft tuberculosis is very rare. We report two cases of isolated allograft tuberculosis and one case of allograft tuberculosis with coexistent pleuro-pulmonary and bone marrow involvement. All three cases had presented with pyrexia of unknown origin, wherein despite extensive investigations the cause was not found. In two cases the diagnosis was confirmed on histology. Two cases responded to non-rifampicin-based modified antitubercular treatment and one to conventional four-drug Rifampicin-based regimen. Graft function improved in two cases while in one case the graft was lost. Tuberculosis involving the renal allograft is a potential cause for graft dysfunction/loss and requires a high index of suspicion for diagnosis. Timely detection and early institution of therapy can help save the renal allograft.

Topics: Adult; Antibiotics, Antitubercular; Biopsy; Bone Marrow; Drug Therapy, Combination; Female; Fever of Unknown Origin; Graft Rejection; Graft Survival; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Middle Aged; Rifampin; Transplantation, Homologous; Treatment Outcome; Tuberculosis, Pleural; Tuberculosis, Pulmonary; Tuberculosis, Renal; Ultrasonography, Doppler, Color

Topics: Antibiotics, Antitubercular; Cross Infection; Health Personnel; Humans; Immunosuppression Therapy; Kidney Transplantation; Recurrence; Rifampin; Tuberculosis, Renal

Topics: Aminosalicylic Acids; Ethambutol; Female; Humans; Hypersensitivity, Delayed; Isoniazid; Male; Mycobacterium tuberculosis; Recurrence; Rifampin; Streptomycin; Tuberculosis; Tuberculosis, Cardiovascular; Tuberculosis, Female Genital; Tuberculosis, Lymph Node; Tuberculosis, Male Genital; Tuberculosis, Meningeal; Tuberculosis, Osteoarticular; Tuberculosis, Pulmonary; Tuberculosis, Renal; United States

Topics: Aminosalicylic Acids; Antitubercular Agents; Child; Child, Preschool; Cycloserine; Drug Resistance, Microbial; Drug Therapy, Combination; Ethionamide; Female; Follow-Up Studies; Humans; Hypertension, Renal; Isoniazid; Kanamycin; Male; Nephrectomy; Pyridoxine; Radiography; Rifampin; Tuberculosis, Renal; Tuberculosis, Urogenital; United States

Topics: Adult; Aged; Aminosalicylic Acids; Clinical Trials as Topic; Drug Combinations; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Rifampin; Streptomycin; Tuberculosis, Pulmonary; Tuberculosis, Renal

Topics: Antitubercular Agents; Diagnosis, Differential; Echocardiography; Female; Fever of Unknown Origin; Humans; Middle Aged; Mycobacterium tuberculosis; Positron-Emission Tomography; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Renal

To explore the application value of GeneXpert MTB/RIF for detection of extra-pulmonary tuberculosis and resistance to rifampin.. A total of 150 samples were collected, including 33 needle aspirates from lymphoid tuberculosis, 23 needle aspirates from spinal tuberculosis, 49 from tuberculous pleural effusions, 24 from cerebrospinal fluid of tuberculous cephalomeningitis, and 21 urinary sediment samples from renal tuberculosis. Smear microscopy, mycobacterium tuberculosis culture and the MTB/RIF method were used to examine these samples and their positive rates were compared. Rifampin susceptibility tests was performed for culture-positive strains using proportion method, which was compared with the result from GeneXpert MTB/RIF method.. Of the 150 cases of extra-pulmonary tuberculosis, 17 samples were smear-positive, with a sensitivity of 11.3% (17/150); 30 were culture-positive with a sensitivity of 20.0% (30/150); and 96 were positive by MTB/RIF method with a sensitivity of 64.0% (96/150). There was a significant difference between MTB/RIF method and the culture method (χ(2)=59.61, P<0.01). The differences were also significant when the MTB/RIF method was compared with the smear method (χ(2)=88.60, P<0.01) or compared with culture plus smear methods (χ(2)=4.26, P<0.05). Separately, the differences were statistically significant between GeneXpert MTB/RIF method and other 2 methods for diagnosis of lymphoid tuberculosis (n=33, χ(2)=20.56, P<0.01 vs. culture method; χ(2)=27.13, P<0.01 vs. smear results) while no difference was found between culture and smear method (χ(2)=0.67, P>0.05), spinal tuberculosis (n=23, χ(2)=12.74, P<0.01 vs. culture method; χ(2)=14.81, P< 0.01 vs. smear method), tuberculous pleurisy (n=49, χ(2)=32.34, P<0.01 vs.culture method; χ(2)=49.69, P<0.01 vs. smear method) and renal tuberculosis (n=21, χ(2)=4.20, P<0.05 vs. culture method; χ(2) =8.40, P<0.01 vs. smear results). The sensitivity for tuberculous meningitis had no difference among these 3 methods (n=24, P>0.05). Rifampicin-resistance of the strains from the 30 culture-positive cases of extra-pulmonary tuberculosis (20.0%, 6/30) exhibited agreement with GeneXpert MTB/RIF test.. The simplicity and high sensitivity of GeneXpert MTB/RIF technology make it a good diagnostic test for rapid detection of extra-pulmonary tuberculosis and resistance to rifampin.

Topics: Antitubercular Agents; Humans; Microbial Sensitivity Tests; Molecular Diagnostic Techniques; Mycobacterium tuberculosis; Needles; Pleural Effusion; Rifampin; Sensitivity and Specificity; Tuberculosis; Tuberculosis, Lymph Node; Tuberculosis, Meningeal; Tuberculosis, Renal; Tuberculosis, Spinal

Dysuria is a very common symptom, which is taken lightly. It can lead to a diagnosis of disseminated Koch's, which if identified early can prevent permanent sequelae.

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Dysuria; Ethambutol; Female; Humans; Isoniazid; Pyrazinamide; Rifampin; Tuberculosis, Female Genital; Tuberculosis, Renal; Urine

Renal tuberculosis is rare in children and particularly in infants. We present a case of miliary tuberculosis with focal renal involvement in a 5-month-old male infant recently adopted from Ethiopia, and review the literature on miliary and renal tuberculosis in infants and children. Salient points regarding tuberculosis screening in internationally adopted patients are also addressed.

Topics: Adoption; Antitubercular Agents; Developing Countries; Ethiopia; Humans; Infant; Isoniazid; Male; Mycobacterium tuberculosis; Pyrazinamide; Rifampin; Tuberculosis, Miliary; Tuberculosis, Renal; United States

A 38-year-old man presented to us with a left sided pleural effusion. Pleural fluid was aspirated and analysis revealed it to be an exudate with predominant lymphocytes and an elevated ADA level. He was discharged on antituberculous treatment. Patient returned with re-accumulation of pleural fluid. Computed tomography done in our institute picked up not only parenchymal disease in the lung which was not evident on chest radiographs but also picked up an abdominal mass in the left renal fossa. Pathological examination of excised mass revealed its tuberculous nature. The repeated recollection of pleural fluid was attributed to a "paradoxical response"; the patient was reassured and his anti-tuberculous treatment continued. Recognition of the fact that evidence of tuberculosis at distant sites may occasionally be needed to substantiate the diagnosis of tuberculous pleural effusion in a difficult and bacteriologically "negative" case prompted us to report this case.

Topics: Adult; Antitubercular Agents; Drainage; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Male; Pleural Effusion; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Pulmonary; Tuberculosis, Renal

Opportunistic infections, and in particular tuberculosis (TB), carry substantial morbidity and mortality in solid organ transplant recipients. We report a 39-year-old man who underwent a cadaveric renal transplant. Three months postoperatively, he was diagnosed to have tuberculous infection of his graft kidney manifested as fever and renal impairment. The diagnosis was confirmed by renal biopsy, which showed granuloma formation and positive stain for acid-fast bacilli (AFB). His systemic symptoms responded well to a complete course of anti-tuberculous therapy, but his renal function continued to deteriorate. Graft nephrectomy was performed and the patient underwent a second kidney transplant 1 year later. He remained well and asymptomatic thereafter. No signs of recurrence of tuberculous infection were noted up until the present time. This case illustrates that TB remains an important threat to transplant recipients. Although reactivation of dormant TB is the usual mode of infection, acquisition from the donor graft is also possible. The latter may account for the infection in our case, as our patient had a negative tuberculin skin test and normal chest radiograph prior to transplant. The identification of AFB in the kidney graft less than 3 months postoperatively also suggested that causal relationship. While diagnosing TB in post-transplant recipients is difficult and may require renal biopsy, as in our case, treatment on the other hand is no different from the standard protocols. However, no consensus has been reached on the safety of re-transplantation. Also, the need for graft nephrectomy and chemoprophylaxis remains unclear.

Topics: Adult; Antitubercular Agents; Ethambutol; Humans; Immunosuppression Therapy; Isoniazid; Kidney Transplantation; Male; Opportunistic Infections; Pyrazinamide; Reoperation; Rifampin; Tuberculosis, Renal

Tuberculous ureteral stricture causing progressive obstructive uropathy commonly complicates renal tuberculosis. The aim of our study was to evaluate the effectiveness of early ureteral stenting or percutaneous nephrostomy (PCN) in patients with tuberculous ureteral strictures.. Seventy-seven patients (84 renal units) with tuberculous ureteral strictures were analyzed. We evaluated the final outcome of involved kidneys with three different managements: medication only (N = 37), medication plus ureteral stenting (N = 28), or medication plus PCN (N = 19).. The overall nephrectomy rate was 51%. In patients treated with medication only, the nephrectomy rate was 73%, whereas the nephrectomy rate was 34% in patients treated with medication plus early ureteral stenting or PCN. The rate of reconstructive surgery for ureteral strictures also was significantly different for patients treated with medication only (8%) and those receiving medication plus early ureteral stenting or PCN (49%). Spontaneous resolution of the strictures was noted in 6 of the 12 renal units that were managed with early ureteral stenting.. Early ureteral stenting or PCN in patients with tuberculous ureteral strictures may increase the opportunity for later reconstructive surgery and decrease the likelihood of renal loss.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Chi-Square Distribution; Constriction, Pathologic; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Nephrectomy; Nephrostomy, Percutaneous; Rifampin; Stents; Time Factors; Treatment Outcome; Tuberculosis, Renal; Ureter; Ureteral Obstruction

State Research Center for Applied Microbiology, Russian Research Institute of Phthisiopulmonology (Ministry of Health, Moscow).. To analyze drug-resistant clinical isolates of Mycobacterium tuberculosis obtained from patients referred to the institute from different parts of Russia, and to study the mechanisms of their rifampicin resistance.. Fifty clinical isolates of M. tuberculosis were analysed. Polymerase chain reaction (PCR) and sequencing were used to study the mechanisms of rifampicin resistance in 25 isolates.. Among cultures isolated from 50 patients, drug resistance was detected in 33. Most of the isolates were resistant to rifampicin (25 isolates), isoniazid (14 isolates), and streptomycin (seven isolates). Only 6% of the isolates were resistant to one drug, while 14% were resistant to two, 32% to three, 40% to four, and 8% to five drugs. Susceptible isolates were derived from 17 patients. The following point mutations and deletions in the rpoB locus, responsible for high level rifampicin resistance (more than 50 microg/ml in egg-based medium), were detected: G-->A/395 (Arg-->Gln), C-->T/232 (His-->Tyr), C-->T/221 (Ser-->Leu), G-->T/202 (Asp-->Tyr), GA-->TT/202-203 (Asp-->Phe), deltaATGGACCAG/199-207 (Met, Asp, Gin), A-->T/91 (Met-->Leu), TG-->CC/227-228 (Leu-->Ser), GAG-->AGT/349-350-351 (Gln-->Ser), deltaGGG/354(Gly).. A number of previously unrecognised genetic modifications in the rpoB region were found in rifampicin-resistant strains isolated from patients from different parts of Russia.

Topics: Adult; Antitubercular Agents; Child; DNA, Bacterial; Drug Resistance, Microbial; Female; Humans; Male; Mycobacterium tuberculosis; Point Mutation; Polymerase Chain Reaction; Rifampin; Russia; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary; Tuberculosis, Renal

A 23-year-old woman developed progressive obstructive uropathy due to multiple renal infundibular and ureteral strictures while on drug treatment for renal tuberculosis. Communication between isolated upper and mid-pole calyces, and the ureter, was established by percutaneous guidewire manipulation. The strictures were successfully managed using percutaneous balloon catheter dilatation and ureteral stenting without the need for open surgical exploration. Kidney function was preserved at one year follow-up.

Topics: Adult; Antitubercular Agents; Catheterization; Constriction, Pathologic; Female; Follow-Up Studies; Humans; Isoniazid; Kidney Calices; Kidney Pelvis; Nephrostomy, Percutaneous; Pyridoxine; Rifampin; Stents; Tuberculosis, Renal; Ureteral Diseases

Urinary tuberculosis is a rare disease in children. It poses major diagnostic problems because of clinical symptoms, which are often atypical and misleading. It causes serious lesions which are often multifocal and extensive, requiring complex surgical excision and urinary tract reconstruction. Prevention of this disease is based on generalized vaccination with BCG and adequate treatment of pulmonary tuberculosis. The authors report a case of urinary tuberculosis in a fourteen-year-old child who presented episodes of cystitis and hematuria refractory to treatment. The diagnosis, confirmed by the positive test for AFB in the urine was established late, at the stage of silent kidney and scleroatrophic bladder. The patient was treated with antituberculous chemotherapy (Isoniazid; Rifampicin, PZA) and nephro-ureterectomy with augmentation enterocystoplasty.

Topics: Adolescent; Antitubercular Agents; Atrophy; Bacteriuria; BCG Vaccine; Child; Cystitis; Hematuria; Humans; Isoniazid; Male; Mycobacterium tuberculosis; Nephrectomy; Pyrazinamide; Rifampin; Sclerosis; Tuberculosis, Pulmonary; Tuberculosis, Renal; Tuberculosis, Urogenital; Ureter; Urinary Bladder; Urinary Bladder Diseases

The authors report a series of 40 cases of genitourinary tuberculosis diagnosed and treated in the department of urology "B" of Avicenne hospital over a 7-year period. The objective of this study is to define the various diagnostic and therapeutic aspects of this disease. The patients were predominantly males (62.5%) with a mean age of 40 years. 25% of cases reported a history of extra-urinary tuberculosis. The very polymorphous clinical presentation is dominated by signs of cystitis (45%). Intravenous urography is frequently suggestive of the diagnosis based on the appearance and multiplicity of the lesions. The radiological lesions most frequently encountered were silent kidney (19 cases) and small tuberculous bladder (11 cases). The definitive diagnosis was established by pathological examination in 38 cases (biopsies, operative specimens, prostatic resection chips) and/or by demonstration of AFB in 2 cases (urine, pus). Tuberculostatic treatment was administered to all patients, either alone (5 cases) or, more usually, in combination with surgical and/or endo-urological treatment (35 cases), reflecting the magnitude and severity of the destructive and scar lesions.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Biopsy; Combined Modality Therapy; Constriction, Pathologic; Cystitis; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Nephrectomy; Prostatic Diseases; Pyrazinamide; Rifampin; Stents; Tuberculosis, Male Genital; Tuberculosis, Renal; Tuberculosis, Spinal; Tuberculosis, Urogenital; Ureteral Diseases; Urinary Bladder Diseases; Urography

Topics: Humans; Male; Middle Aged; Purpura, Thrombotic Thrombocytopenic; Rifampin; Tuberculosis, Renal

A plasmapheresis (PA) model was developed to be used in chronic rabbit experiments. Test results obtained in 96 generalized tuberculosis animals demonstrated a more benign tuberculosis process in animals subjected to plasmapheresis, which was confirmed by parameters of the coefficients of mass and indices of animals' organ affecting, findings of the cation-lysosomal test and peptide molecules content in the peripheral blood. Rabbit studies involving registration of bromsulphalein half-life, hepatic blood flow and relative parenchymatous clearing showed that the isoniazide and rifampicin action significantly decreased under the PA influence. Studies in a hospital accommodating 90 patients with different renal tuberculosis forms and poor tuberculostatic tolerance showed that PA promoted restoration of tolerance to specific preparations and renal function improvement. PA was found to be practicable and safe method which relieves side effects of antituberculous preparations and contributes to tuberculosis treatment efficiency.

Topics: Animals; Chemical and Drug Induced Liver Injury; Combined Modality Therapy; Disease Models, Animal; Drug Tolerance; Humans; Isoniazid; Mycobacterium bovis; Plasmapheresis; Rabbits; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Renal

We describe the results of eight patients with renal tuberculosis treated with rifampin, isoniazid and ofloxacin. Ofloxacin was given orally, 200 mg b.i.d. for 6 months. During the first three months, rifampin (600 mg/daily) and isoniazid (330 mg/daily) were added. All M. tuberculosis strains isolated were sensitive to ofloxacin (MIC 1 mg/l). Follow-up cultures turned to be negative rapidly (during the first month of therapy), and no untoward effects were recorded. All patients had a 12-months follow-up period, and all were clinically cured. The treatment used was well accepted by all patients.

Topics: Adolescent; Adult; Antitubercular Agents; Drug Therapy, Combination; Female; Humans; Isoniazid; Male; Middle Aged; Ofloxacin; Rifampin; Tuberculosis, Renal

Topics: Aged; Drug Interactions; Female; Glyburide; Humans; Rifampin; Tuberculosis, Renal

We report a patient who developed progressive renal failure following 13 months of rifampicin therapy for renal tuberculosis. The renal function continued to deteriorate despite the discontinuation of rifampicin. Renal pathology did not demonstrate any evidence of tuberculosis of the kidney but revealed the unique pathological finding of glomerulosclerosis, granulomatous interstitial nephritis, and extensive papillary necrosis.

Topics: Adult; Female; Glomerulosclerosis, Focal Segmental; Humans; Kidney Papillary Necrosis; Nephritis, Interstitial; Rifampin; Tuberculosis, Renal; Uremia

Topics: Addison Disease; Adrenal Insufficiency; Glucocorticoids; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Renal

The use of antituberculotic short-term chemotherapeutic methods did not yet make its way on a larger scale in the treatment of the extrapulmonary tuberculosis on account of supposed peculiarities of the terrain. Therefore, the present clinical and experimental study had the aim to investigate the distribution of INH and RMP in the kidney and the radiometrical determination of their concentration directly in the tuberculous focus of the kidney. For this purpose the tritium labelling of the two basis antituberculotics mentioned was carried out. Apart from the description of the applied working and measuring technique, questions of the distribution of medicaments are discussed. The results made evident that also in kidneys widely destroyed by tuberculosis both INH after an intravenous application of 300 mg and RMP after oral application of 600 mg even in large tuberculous caverns achieve antimycobacterially effective concentrations. Indeed, there are considerable differences, however, the values were always far above the minimum inhibition concentration. Thus there are no terrain-caused peculiarities for the tuberculous kidney and also no restrictions as to the use of an optimized antituberculotic chemotherapy. The same is probably also applied to all other forms of the extrapulmonary tuberculosis. The newly developed method distinguishes itself by a high measuring exactness and could analogously be used in questions of the chemotherapy of malignant tumours.

Topics: Adult; Aged; Drug Therapy, Combination; Female; Humans; Isoniazid; Kidney; Male; Middle Aged; Rifampin; Tuberculosis, Renal

Topics: Animals; Drug Therapy, Combination; Ethambutol; Isoniazid; Rabbits; Rifampin; Tuberculosis, Renal

Rifampicin excretion with urine and its plasma levels were studied in 46 patients with nephrophthisis treated with rifampicin alone or in combination with isoniazid in doses of 8--10 mg/kg bw with regard to the degree of renal insufficiency. It was shown that excretion of rifampicin with urine decreased with progression of renal insufficiency and had no effect on its plasma levels. The combined use of isoniazid and rifampicin in a single dose was accompanied by a decrease in the latter's excretion with urine and different changes in its plasma concentration. The use of the two drugs for 4--6 weeks resulted in a further decrease in rifampicin excretion with urine not dependent on renal function and in decreased plasma levels of the antibiotic in 1/3 of patients. The findings indicate that the use of rifampicin in a dose less than 10 mg/kg of the body weight in patients with chronic renal insufficiency is not advisable. The absence of rifampicin in the urine specimens collected during the first hours on the 2nd day after its single use or its use for 4--6 weeks indicate that rifampicin does not accumulate in patients with renal insufficiency.

Topics: Administration, Oral; Drug Therapy, Combination; Humans; Isoniazid; Kidney Failure, Chronic; Kidney Function Tests; Kinetics; Rifampin; Time Factors; Tuberculosis, Renal

A case is presented of local recurrence of tuberculosis after successful hip arthrodesis, in a patient subsequently found to have active asymptomatic renal tuberculosis. The possibility of hematogenous spread is raised, and the importance of thorough genitourinary evaluation in cases of reactivated skeletal tuberculosis is discussed.

Topics: Arthrodesis; Ethambutol; Female; Hip Joint; Humans; Isoniazid; Joint Diseases; Knee Joint; Middle Aged; Radionuclide Imaging; Recurrence; Rifampin; Shoulder Joint; Tomography, X-Ray Computed; Tuberculosis, Osteoarticular; Tuberculosis, Renal

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Humans; Male; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Renal

Topics: Adult; Drug Evaluation; Drug Therapy, Combination; Ethambutol; Humans; Kidney; Middle Aged; Preoperative Care; Rifampin; Tuberculosis, Renal; Ureteral Diseases

The therapy of genitourinary tuberculosis has changed: 'néphrectomie nécessaire' has been replaced by 'néphrectomie opportune'. Today, it is generally assumed that tuberculosis can be cured completely by chemotherapy. The following question must, however, be asked: How far may the stable sterility of the urine be considered as a complete cure? In order to assess the efficiency of chemotherapy as a function of time and dosage, the activity of tuberculosis of the kidneys was investigated on the basis of the histological preparation, after removal of the tuberculous renal tissue. Despite stable sterilization of the urine, 15% of the cases showed active tuberculosis. Using the triple therapy combination of rifampicin, ethambutol and isoniazid, the disease was found no longer to be active after 2--3 months of treatment in 90% of the cases. A longer period of treatment brought no further improvement.

Topics: Capreomycin; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Nephrectomy; Retrospective Studies; Rifampin; Tuberculosis, Renal

A fifty-seven year old male with renal tuberculosis developed pseudomembranous colitis on rifampicin and ethambutol. Diarrhoea occurred within a week, and six weeks after commencing these antituberculous agents he developed typical sigmoidoscopic and biopsy findings. Withdrawal of the drugs led to rapid recovery. Repeated challenge testing indicated that the symptoms were worse when rifampicin was given, but a test dose of ethambutol also produced temporary aggravation of the diarrhoea.

Topics: Biopsy; Drug Therapy, Combination; Enterocolitis, Pseudomembranous; Ethambutol; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Renal

The renal tuberculosis is one of the most important manifestations of the extrapulmonary tuberculosis. There was no decrease in the number of new cases in recent years. A report is given on 213 patients with renal tuberculosis, who were treated stationary in the years 1968 and 1978. Chemotherapy was in renal tuberculosis as successful as in pulmonary tuberculosis. Nephrectomy was performed in 17.3% of the cases. Early nephrectomy is a thing of the past. The duration of hospitalisation is shortened to about 3 months. Chemotherapy should take about one year.

Topics: Ethambutol; Female; Humans; Isoniazid; Male; Nephrectomy; Prothionamide; Rifampin; Streptomycin; Tuberculosis, Renal; Urine; Urography

A 5-year experience is presented with a new regimen for renal tuberculosis, consisting of isoniazid, ethambutol and rifampin. This regimen has proved satisfactory to date and compares favorably to previous regimens. A plea for long-term therapy is made until further study of short-term treatment proves it to be free of recurrences.

Topics: Adult; Aged; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Middle Aged; Pyridoxine; Rifampin; Time Factors; Tuberculosis, Renal

Two cases are reported of hemolytic crisis and acute anuria after intermittent rifampicin medication. Immunologic tests demonstrate that the hemolysis was of the drug-induced heteroimmune type whereas the pathogenesis of the anuria was uncertain. For both complications the prognosis is good.

Topics: Acute Kidney Injury; Aged; Antibodies; Anuria; Drug Therapy, Combination; Female; Hemolysis; Humans; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Lymph Node; Tuberculosis, Renal

Topics: Adult; Aphasia; Carotid Artery Diseases; Carotid Artery, Internal; Cerebral Infarction; Cerebral Ventricles; Cerebrospinal Fluid; Encephalitis; Female; Humans; Male; Middle Aged; Rifampin; Streptomycin; Tuberculosis, Meningeal; Tuberculosis, Miliary; Tuberculosis, Renal

The clinical and bacteriological results of 200 cases of renal tuberculosis treated with rifampicin (RFM), isoniazid (INH) and ethambutol (EMB) over a period of 4 months to 2 years are presented. This combination produced the highest theoretical score.

Topics: Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Radiography; Rifampin; Tuberculosis, Renal; Urine

271 renal cavities from 94 nephrectomies were studied with fluorescence stain and Lowenstein-Jensen medium cultures. The degree of the sterilization of the lesions is demonstrated by the existence of Koch's bacilli into the cavities. The latter have been classified in different development stages according to their contents and the histological aspect of the wall. The results of this study showed that a reduced healing time allows a better conservation of the parenchyma. The in vivo rifampicin + isoniazid + ethambutol association produces the best and quickest stabilization of the cavities.

Topics: Ethambutol; Evaluation Studies as Topic; Humans; Isoniazid; Kidney; Rifampin; Tuberculosis, Renal

Topics: Acute Kidney Injury; Aged; Ethambutol; Female; Humans; Immunoglobulin Light Chains; Isoniazid; Male; Middle Aged; Proteinuria; Rifampin; Tuberculosis, Lymph Node; Tuberculosis, Renal

Topics: Aged; Chemical and Drug Induced Liver Injury; Female; Humans; Liver Function Tests; Pemphigus; Prednisone; Remission, Spontaneous; Rifampin; Tuberculosis, Renal

Renal tuberculosis will continue to be a potentially lethal disease and must be considered a diagnostic possibility in all patients with infection in order to discover it in time. Multiple drug regimens have withstood the test of time and it appears that triple drug therapy is more efficacious than 2 drugs since triple drugs permit the skipping of 1 or another of the medications with less danger of relapse. Rifampin is a new drug that is well tolerated and efficacious, although expensive. We recommend continuous use of triple drugs for 2 years at least with the continuance of pyridoxine. We advise an excretory urogram, the collection of 3 urine specimens for culture and the passage of ureteral catheters every 6 months during treatment and every 12 months thereafter for 10 years. We do not consider relapse an indication for an operation but for further therapy, using medications to which the patient's organism is proved susceptible by bacteriologic means. Under modern conditions an operation is rarely necessary.

Topics: Aminosalicylic Acids; Bilirubin; Color Perception; Cycloserine; Drug Evaluation; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Kidney; Liver; Lung Diseases; Male; Rifampin; Tuberculosis, Renal; Visual Perception

Topics: Adult; Drug Therapy, Combination; Female; Humans; Male; Rifampin; Streptomycin; Tuberculosis, Renal

Topics: Aminosalicylic Acids; Cell Migration Inhibition; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Immunity, Cellular; In Vitro Techniques; Isoniazid; Macrophages; Rifampin; Tuberculosis, Lymph Node; Tuberculosis, Meningeal; Tuberculosis, Pulmonary; Tuberculosis, Renal

Topics: Adolescent; Adult; Antitubercular Agents; Drug Therapy, Combination; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Streptomycin; Tuberculosis, Renal

Topics: Acute Kidney Injury; Agglutination Tests; Anemia, Hemolytic; Antibodies; Female; Hemolysis; Humans; Middle Aged; Rifampin; Tuberculosis, Renal

Topics: Adult; Aminosalicylic Acids; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Tuberculosis, Renal

Topics: Humans; Kidney; Male; Rifampin; Tuberculosis, Renal

Topics: Humans; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Renal

Topics: Female; Humans; Male; Nephrectomy; Prognosis; Rifampin; Transaminases; Tuberculosis, Renal; Tuberculosis, Urogenital; Ureteral Diseases; Urinary Bladder Diseases

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Rifampin; Tuberculosis, Renal; Tuberculosis, Urogenital

Topics: Adult; Alkaline Phosphatase; Bilirubin; Female; Humans; Jaundice; Rifampin; Transaminases; Tuberculosis, Renal

Topics: Adult; Aged; Anti-Bacterial Agents; Drug Resistance, Microbial; Drug Synergism; Drug Tolerance; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Renal

Topics: Adolescent; Adult; Age Factors; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Streptomycin; Tuberculosis, Renal; Tuberculosis, Urogenital; Urinary Bladder

Topics: Aminosalicylic Acids; Drug Resistance, Microbial; Female; Humans; Hypertension, Renal; Isoniazid; Male; Nephrectomy; Rifampin; Streptomycin; Tuberculosis, Renal; Tuberculosis, Urogenital; Ureter; Ureteral Diseases; Urinary Bladder

Topics: Antitubercular Agents; Drug Combinations; Ethambutol; Humans; Isoniazid; Rifampin; Tuberculosis, Renal