فهرست نشریات علمی دسترسی آزاد ایران

Introduction: Spontaneous nephrocutaneous fistula is a rare manifestation of renal disease that can occur due to various etiologies,such as renal calculus, chronic pyelonephritis, stricture of the ureteropelvic junction, and renal tuberculosis (TB). An autonephrectomywith a nephrocutaneous fistula due to renal tuberculosis can be diagnosed quite late if it is not suspected.Case Presentation: We report a case of a spontaneous nephrocutaneous fistula with tuberculous autonephrectomy. A 40-year-oldwhite male with recurrent flank pain and intermittent purulent drainage from his right flank region for the previous 14 years wasadmitted to our outpatient clinic. Fistulography and computerized tomography demonstrated a 5160mmarea with a soft-tissueappearance that implied autonephrectomy of the right kidney, and a fistula tract with a 9mmdiameter between the skin and theretroperitoneal space. The patient was successfully treated with nephroureterectomy and excision of the fistulous tract, followedby antituberculous treatment. The pathological examination of the surgical specimen revealed chronic atrophic pyelonephritis,calcifications, and necrotizing granulomatous inflammation suggestive of TB.Conclusions: Urogenital TB is difficult to diagnose due to the lack of specific symptoms and signs. In the case of a nonfunctioningkidney without an obvious cause and a chronic spontaneous nephrocutaneous fistula, the possibility of associated renal TB shouldbe kept in mind, especially in immunocompromised patients or in places where TB is a common health problem.