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Renal medicine
Urogenital tuberculosis in a patient with persistent sterile pyuria
  1. Gonçalo Pimenta,
  2. Maria Inês Roxo,
  3. Rita Birne and
  4. Tiago J Carvalho
  1. Nephrology, Unidade Local de Saude de Lisboa Ocidental, Lisbon, Portugal
  1. Correspondence to Dr Tiago J Carvalho; tiagojc18{at}hotmail.com

Abstract

Urogenital tuberculosis (UGTB) can be a challenging diagnosis, and a delay in treatment may lead to irreversible organ damage. We report the case of a Guinean man in his 40s, residing in Portugal, who presented with lower urinary tract symptoms, urethral discharge and a right scrotal mass. Laboratory results revealed acute kidney injury, hypercalcaemia and persistent sterile pyuria, and ultrasound findings were suggestive of orchiepididymitis. Interferon gamma release assay was positive, as were the urine cultures for Mycobacterium tuberculosis, confirming the diagnosis of UGTB. The patient was initiated on tuberculostatic drugs, with a favourable response. This case emphasises the high degree of suspicion needed to establish the diagnosis of UGTB, which should be considered in patients with persistent sterile pyuria and a relevant epidemiological context.

  • TB and other respiratory infections
  • Urinary tract infections

https://doi.org/10.1136/bcr-2024-264594

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    Footnotes

    • GP and MIR are joint first authors.

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: GP (first author), MIR (first author), RB and TJC. The following authors gave final approval of the manuscript: GP, MIR, RB and TJC. Guarantor: TJC.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.