Conclusions

GUTB can progress insidiously and lead to irreversible renal destruction years after treated pulmonary TB. A putty kidney represents an end-stage, nonfunctioning organ that often necessitates nephrectomy. This case illustrates that end-stage GUTB may remain clinically silent for years and be detected incidentally despite previous treatment for pulmonary TB. Long-term clinical vigilance should be maintained in patients with previous TB, particularly when new symptoms or suspicious imaging findings develop. Routine imaging surveillance for all patients with previous TB is not established by current evidence.