International Journal of Health Sciences & Research (www.ijhsr.org) 127 Vol.2; Issue: 5; August 2012 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Case Report Classical Renal Tuberculosis Presented As Recurrent Sterile Pyuria and End Stage Kidney Sunil V. Jagtap 1 , Dhiraj B. Nikumbh 1@ , Sujata R. Kanetkar 1 , Ravindra Agarwal 2 , Vasim Khatib 1 1 Department of Pathology, 2 Consultant Urologist Krishna Institute of Medical Sciences University and Krishna Hospital and Research Center, Karad @ Correspondence Email: drdhirajnikumbh@rediffmail.com Received: 12/07//2012 Revised: 06/08/2012 Accepted: 13/08/2012 ABSTRACT Genitourinary tuberculosis (GUTB) is the most frequent type of extrapulmonary tuberculosis. However the diagnosis is generally missed due to lack of classical signs and symptoms of renal tuberculosis (TB). As the signs and symptoms of renal tuberculosis mimics those of other infections of the kidney such as sterile pyuria, pain in abdomen, blood in urine etc. Clinical suspicion of this rare entity is necessary to prevent unnecessary avoidable complications as end stage renal disease. Evidence as TB is a cause of end stage renal failure worldwide, is very scanty. Herein we report a rare case of 35 years old female presented with recurrent sterile pyuria and end stage kidney. The patient later on histopathologically diagnosed as classical / primary renal tuberculosis, as clinical and imaging modalities suggested right kidney was the primary site of the infection. Keywords: Genitourinary tuberculosis, primary tuberculosis, sterile pyuria, tuberculosis, end stage kidney. INTRODUCTION Tuberculosis (TB) is a common disease with 8-10 million new cases occurring annually worldwide. After lymphadenopathy, the most common form of non pulmonary TB is genitourinary tuberculosis (GUTB), accounting for 27 % (with a range of 14-41%) of several surveys in USA, Canada and the UK. [1] The incidence of GUTB in developing countries as India is still alarming in view of ill health, lower socioeconomic status and high incidence of HIV infection. [1] GUTB is a relatively uncommon and under recognized disease worldwide. 2 GUTB is often missed by the physicians due to lack of suspicion, negligence and rarity of