The classic renal manifestation of tuberculosis is the presence of microscopic pyuria with a sterile urine culture—or “sterile pyuria.” More often, other bacteria are also present. Microscopic hematuria is often present with pyuria. Urine cultures are the gold standard for diagnosis. Three to six first morning midstream specimens should be performed to improve sensitivity. Papillary necrosis and cavitation of the renal parenchyma occur less frequently, as do ureteral strictures and calcifications. Adequate drug therapy can result in resolution of renal involvement.
et al. Urogenital tuberculosis. Microbiol Spectr. 2017 Jan;5(1).