Tuberculous spondylodiscitis with ureteral involvement: a rare case report.

Abstract

Background: Tuberculosis spondylitis, also known as Pott's disease, is a form of osteomyelitis that primarily affects the vertebral bodies and can lead to severe complications such as paravertebral abscesses, kyphosis, and degenerative spinal changes. Although it typically involves the skeletal system, contiguous spread to adjacent organs, such as the genitourinary tract, is rare.

Methods: We report the case of a 64-year-old male with chronic back pain who underwent a renal protocol abdominopelvic CT scan following ultrasound findings of right kidney stasis.

Results: The CT revealed obstructive uropathy with a dilated and tortuous ureter, a 27×30 mm intraluminal lesion, intraluminal gas, and periureteric fibrosis. Fusion of the L3-L5 vertebrae with gibbous deformity and degenerative changes suggested tuberculous spondylodiscitis with extension to the ureter. Urinalysis was positive for acid-fast bacilli, confirming genitourinary tuberculosis. The patient underwent right ureteronephrectomy due to pyonephrosis and extensive adhesions precluding ureteral reconstruction.

Conclusion: This case highlights a rare but serious complication of spinal tuberculosis involving direct spread to the ureter. Timely diagnosis using imaging and microbiological testing, followed by appropriate surgical intervention, is critical to prevent long-term morbidity.