Title Urogenitalna tuberkuloza u 21. stoljeću
Title (english) Urogenital tuberculosis in 21st century
Author Matea Stošić
Mentor Dean Markić (mentor)
Committee member Josip Španjol (predsjednik povjerenstva)
Committee member Romano Oguić (član povjerenstva)
Committee member Ivan Bubić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Urology) Rijeka
Defense date and country 2018-07-13, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Urology
Abstract Tuberkuloza je kronična, zarazna bolest koju uzrokuje bacil, M. tuberculosis. Primarno zahvaća pluća, međutim moguću komplikaciju predstavlja hematogeni rasap, posljedično zahvaćajući bilo koji drugi organ, pa tako i urogenitalni sustav. Zahvaćanje samog bubrega, točnije parenhima je dosta rijetka pojava, nešto češće je zbog svoje prokrvljenosti zahvaćen donji dio urinarnog sustava, te genitalni dio, gdje bacili, ekskrecijom kroz tubule dospiju u urinarni trakt. Simptomi same bolesti nisu specifični, te se najčešće uočavaju slučajnim nalazima. Pacijent se u početku javlja s učestalom, bezbolnom mikcijom te mikrohematurijom i sterilnom piurijom. Ukoliko je bolest uznapredovala i zahvatila mokraćni mjehur, simptomi su izraženiji. Opći simptomi kao što su vrućica, malaksalost, gubitak na težini su rijetkost. Ukoliko se bolest ne prepozna i pravodobno ne liječi, moguće su komplikacije i na udaljenim organima, kao što je zahvaćanje moždanih struktura, meningoencefalitis. U daljnjoj dijagnostici analiziramo urin na M. tuberculosis koju možemo dokazati bojenjem po Ziehl-Neelsenu ili PCR-om, ukoliko je izvedivo. Sigurniji i točniji nalaz će nam omogućiti CT sa kontrastom i ultrazvuk, međutim CT ipak omogućava bolji anatomski prikaz. Postavljanjem dijagnoze urogenitalne tuberkuloze odmah se započinje inicijalna antituberkulotska terapija, no ukoliko lezije napreduju bez obzira na terapiju, neophodno je postavljanje stenta ili perkutane nefrostomije. Kod uznapredovale bolesti a radi sprečavanja mogućih komplikacija, neophodan je kirurški zahvat koji uključuje nefrektomiju, dilataciju ili rekonstrukciju ureteralnih striktura ili augmentaciju mjehura.
Abstract (english) Tuberculosis is a chronic, contagious disease caused by bacillus M. Tuberculosis. The disease primarily affects the lungs, but there is a possibility of a hematogenic spread, resulting in the involvement of any other organ, like urogenital system. Affecting the kidney, more precisely parenchyma is quite rare, something more often tuberculosis affect the lower part of the urinary system because of excretion through the tubule into the urinary tract, and also the genital part because of its good blood circulation. Symptoms are not specific, and they are often observed by random findings. Initially, the patient complains about frequent, painless urination, microhematuria and sterile pyuria. If the disease has progressed and spred on the bladder, the symptoms are more pronounced. General symptoms such as fever, exhaustion, weight loss are rare. If the disease is not recognized and timely treated there is possibility of complicatons on distant organs, such as meningoencephalitis. In further diagnosis we analyze urine on Mycobacterium tuberculosis which may be established by demonstration of tubercle bacili in the urine by acid- fast stain or PCR, if feasible. Furthermore, a safer and more accurate finding will enable us radiographic tools such as CT with contrast and ultrasound, but the CT provides a better anatomical presentation so it is preferred if it is feasible. Establishing a diagnosis of urogenital tuberculosis it is necessary to start immediately initial antituberculatory therapy, but if the lesions progress despite appropriate treatment, a further therapeutic procedure is early stenting or percutaneous nephrostomy. If disease is advanced, or to prevent further complications it is ordered surgical treatment which include nephrectomy, dilatation or reconstruction of ureteral stricture, and bladder augmentation.
Keywords
tuberkuloza
urogenitalna tuberkuloza
antituberkulotska terapija
Keywords (english)
tuberculosis
urogenital tuberculosis
dissemination
antituberculotic therapy
Language croatian
URN:NBN urn:nbn:hr:184:669144
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Access restricted to students and staff of home institution
Terms of use
Created on 2018-11-21 15:45:02