A bacterial infection that primarily affects the lungs. However, in 30% of cases there is involvement of other organs. Kidneys rank as one of the most common extra-pulmonary sites.

Mycobacterium tuberculosis is the responsible organism. After acquiring the initial respiratory infection, 15% of patients disseminate the disease through the blood stream to extrapulmonary sites.

Kidney involvement includes pain in the flank, blood in the urine, painful urination, and urinary frequency. However, at times, the disease may be without symptoms until there has been serious kidney destruction.

A urinalysis can reveal abnormalities, cultures of pus in the urine aid in the diagnosis, and intravenous radiography of the ureters and renal pelvis (pyelogram) manifests pelvic cavities.

Since most organisms are resistant to single drugs, it takes a combination of 4 to 6 drugs to treat tuberculosis. Tuberculosis of the genitourinary (GU) tract responds well to chemotherapy.

Drug toxicity may induce hepatitis, and therapy will need to be discontinued. Patients may undergo a relapse after completing treatment. Organisms that become seeded at a remote site may be dormant and become reactivated at a later time when immunity is compromised, as in human immunodeficiency virus (HIV).

• This disease, (condition), only in its active form , has a 3 year presumptive period and shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied.  38 CFR 3.309(a). [chronic disease].

• Rate in accordance with 38 CFR 4.88(b) or 38 CFR 4.89, whichever is appropriate.

• Nonpulmonary disease -  Determination of complete arrest of nonpulmonary tuberculosis requires absence of evidence of activity for 6 months. If there are two or more foci of such tuberculosis, one of which is active, the condition will not be considered to be inactive until the tuberculous process has reached arrest in its entirety.  38 CFR 3.375(b)

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Total plus 60% and – Special Monthly Compensation (SMC).

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.

• 38 CFR 4.89 Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968 -  Public Law 90–493 repealed section 356 of title 38, United States Code which provided graduated ratings for inactive tuberculosis. The repealed section, however, still applies to the case of any Veteran who on August 19, 1968, was receiving or entitled to receive compensation for tuberculosis. The use of the protective provisions of Pub. L. 90–493 should be mentioned in the discussion portion of all ratings in which these provisions are applied. For use in rating cases in which the protective provisions of Pub. L. 90–493 apply, the former evaluations are retained in this section.

• Following the total rating for the 2-year period after date of inactivity, the schedular evaluation for residuals of nonpulmonary tuberculosis, i.e., ankylosis, surgical removal of a part, etc., if in excess of 50 percent or 30 percent will be assigned under the appropriate diagnostic code for the specific residual preceded by the diagnostic code for tuberculosis of the body part affected. For example, tuberculosis of the hip joint with residual ankylosis would be coded 5001–5250.

• The graduated ratings for nonpulmonary tuberculosis will not be combined with residuals of nonpulmonary tuberculosis unless the graduated rating and the rating for residual disability cover separate functional losses, e.g., graduated ratings for tuberculosis of the kidney and residuals of tuberculosis of the spine. Where there are existing pulmonary and nonpulmonary conditions, the graduated evaluation for the pulmonary, or for the nonpulmonary, condition will be utilized, combined with evaluations for residuals of the condition not covered by the graduated evaluation utilized, so as to provide the higher evaluation over such period.

• These ratings are applicable only to veterans with nonpulmonary tuberculosis active on or after October 10, 1949.

• The ending dates of all graduated ratings of nonpulmonary tuberculosis will be controlled by the date of attainment of inactivity.