title: Urogenital tuberculosis in immunocompromised patients.
abstract: OBJECTIVE
  Compare the clinicoradiological presentation of urogenital tuberculosis (UGT) between immunocompromised and nonimmunocompromised patients.
  
  
  METHODS
  Eighty patients diagnosed with UGT were divided into two groups: eight immunocompromised patients (four with acquired immunodeficiency syndrome [AIDS], and four renal transplant patients on immunosuppressive therapy) and 72 nonimmunocompromised patients. The groups were compared as for age, signs and symptoms, diagnostic approach, pattern of urogenital organ involvement, and early specific mortality (within 6 months from diagnosis).
  
  
  RESULTS
  AIDS patients were younger (median age 26 years, range 16-38 years), and renal transplant patients were older (median age 51.5 years, range 45-57 years), compared with the nonimmunocompromised subjects (median age 35 years, range 12-75 years). Immunocompromised patients had greater frequency of fever (87.5% versus 43.1%, P = 0.024), lower frequency of storage symptoms (37.5% versus 76.4%, P = 0.033), shorter length of disease (<6 months: 87.5% versus 2.8%, P < 0.001), and larger frequency of disseminated tuberculosis (62.5% versus 18.1%, P = 0.012). Predominantly parenchymatous renal involvement was more frequent in immunocompromised patients (87.5% versus 6.2%, P < 0.001), who also had lower frequency of stenosis of the collecting system (12.5% versus 93.8%, P < 0.001) and contracted bladder (12.5% versus 65.3%, P = 0.001).
  
  
  CONCLUSIONS
  UGT has a different clinicoradiological presentation in immunocompromised patients, with predominance of systemic symptoms, disseminated tuberculosis, multiple parenchymatous renal foci, and lower frequency of lesions of the collecting system. In the context of immunosuppression, UGT behaves as a severe bacterial infection, with bacteremia and visceral metastatic foci.
authors.affiliation: Division of Urology, Medical School, University of Sao Paulo, Sao Paulo, Brazil. andreavaresef@gmail.com
authors.forename: Andre Avarese
authors.initials: AA
authors.lastname: Figueiredo
authors.forename: Antonio Marmo
authors.initials: AM
authors.lastname: Lucon
authors.forename: Renato Falci
authors.initials: RF
authors.lastname: Júnior
authors.forename: Diego Shiguemi
authors.initials: DS
authors.lastname: Ikejiri
authors.forename: William Carlos
authors.initials: WC
authors.lastname: Nahas
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology*; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014401:Tuberculosis, Urogenital / Q000175:diagnosis* / Q000276:immunology* / Q000401:mortality; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents