(A)typical (Extra) Pulmonary Tuberculosis in Kidney Patients

Tuberculosis is still a major health problem especially among immunocompromised hosts. Another problem is making diagnosis due to the unexpected presentation and localization of disease. Extrapulmonary disease may clinically and radiographically mimic other infectious or neoplastic diseases. In this report we presented three tuberculosis cases; a kidney allograft recipient and two patients with end stage renal disease including soft tissue abscess, lytic bony lesions and pathological fractures without any pulmonary symptoms. Tuberculosis should be kept in mind during atypical generalized inflammatory conditions especially in immunocompromised hosts. Atypical localization and symptomatology may arise due to the more potent immunosuppressive agents. Delay in diagnosis may cause significant mortality and morbidity in patients with high risk. Starting anti-tuberculosis treatment empirically in most cases due to the difficulties in establishing diagnosis is another problem. Classical anti-tuberculosis treatment is sufficient to control disease in most cases. Early management may be a life saving approach.