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• W4387249619 abstract "SESSION TITLE: Chest Infections Case Report Posters 19 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 02:10 pm - 02:55 pm INTRODUCTION: Acute Renal tuberculosis occurs in about 2 to 20 percent of pulmonary tuberculosis (1) usually due to hematogenous spread. Healed renal tuberculosis with Dystrophic calcification may result in non-functioning totally calcified kidney called 'putty kidney’ or 'cement kidney.’ We present a case of a patient with putty kidney which served to race suspicion that the cavitary lung disease in this patient was due to mycobacterium tuberculosis. CASE PRESENTATION: A 41 year old Nepalese male presented with 3 months of nonproductive cough, chest pain, malaise, anorexia, weight loss, progressive dyspnea and fever. Patient had sodium of 122 mmol/L (136-146), creatinine of 2.78 mg/dl (.7-1.2 mg/dL), BUN 56 mg/dL (6-20), AST 639 U/L (10-50 U/L), ALT 48 U/L (0-41 U/L), white blood cell 11.51 K/uL (4.5-10.9 K/uL), platelets 788 k/uL (130-400 K/uL), high sensitivity C-reactive protein 140.77 mg/L (1-4mg/L), procalcitonin 3.22 ng/dL (0.00-0.5 ng/dL), sedimentation rate >130mm/hr (0-15 mm/hr) and negative for HIV. Chest-x ray revealed bilateral parenchymal airspace disease suspicious for multifocal pneumonia. Computerized tomography (CT) without contrast showed evidence of bi-apical multifocal dense parenchymal opacities with cavitation. A head CT showed prominent calcification in the left occipital lobe, possibly due to prior granulomatous disease. Abdomen and pelvis CT demonstrated atrophic completely calcified right kidney referred as putty/cement kidney indicator if healed renal granulomatous disease as in tuberculosis. Mycobacterium PCR and culture were positive in sputum which proved to be Isoniazid resistant. Patient was treated with Rifampin, Pyrazinamide, levofloxacin with gradual improvement. DISCUSSION: When renal tuberculosis heals, rarely it can lead to dystrophic calcifications which when the entire kidney is involved is referred to as putty/cement kidney as seen in our patient. However, this finding can serve as a clue to the presents of mycobacterium tuberculosis as a cause of the active pulmonary infection. CONCLUSIONS: Extensive dystrophic calcification of the kidney referred to as putty/cement kidney is an uncommon finding of healed renal tuberculosis. When present it can serve as a clue that the active pulmonary infection is due to mycobacterium tuberculosis. This finding can also raise suspicion that tuberculosis may be the cause of active undiagnosed disease seen in other organs. REFERENCE #1: The 10 leading causes of death by broad income group (2008). World Health Organization. http://www.who.int/mediacentre/factsheets/fs310/en/index.html# (accessed 1 Apr 2013). REFERENCE #2: Raviglione MC, Snider DE Jr, Kochi A. Global epidemiology of tuberculosis. Morbidity and mortality of a worldwide epidemic. JAMA 1995;273:220–6. REFERENCE #3: Global Tuberculosis Control 2012. Geneva: World Health Organization, 2012. http://www.who.int/tb/publications/global_report/ (accessed 1 Apr 2013). DISCLOSURES: No relevant relationships by Eleonora Daribayeva No relevant relationships by Aleksandr Khudyakov No relevant relationships by Padmanabhan Krishnan" @default.
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• W4387249619 date "2023-10-01" @default.
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• W4387249619 title "PUTTY KIDNEY: CLUE TO DIAGNOSIS OF PULMONARY TUBERCULOSIS" @default.
• W4387249619 doi "https://doi.org/10.1016/j.chest.2023.07.771" @default.
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