Genitourinary tuberculosis is a primary target of hematogenous infections and is the most common site of extra-pulmonary tuberculosis. A 2-year-old Indonesian boy with genitourinary tuberculosis with family history of tuberculosis. Radiological work-ups show pulmonary miliary tuberculosis, complication of hydronephrosis and ureteral kinking. Centrifuge-urine smear shows acid-resistant bacillus. Anthropometric measured was similar a 1-years-2-months-old boy. The biological activity of tuberculosis can only be assessed by cultivating mycobacteria. The patient was treated with anti-tuberculosis regiments and shows improvement on clinical presentation. He received nutritional intake based on the WHO formula (F75, F100, F135). This patient should undergo reconstructive surgery but refuse.
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