Does pyuria always suggest urinary tract infection with common microorganisms? Questions
Mehmet Taşdemir1, Hüseyin Kaya2, Zeynep Atam Taşdemir3
1Division of Pediatric Nephrology, Department of Pediatrics, Koç University Hospital, Davutpaşa cd no:4 34010, Topkapı, Istanbul, Turkey. mtasdemir@kuh.ku.edu.tr.
Pediatric Nephrology (Berlin, Germany)
|July 20, 2017
Summary
Genitourinary tuberculosis (GUTB) can present unusually as miliary tuberculosis. Early recognition of symptoms like abdominal pain and sterile pyuria is crucial for timely diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Nephrology
- Radiology
Background:
- Genitourinary tuberculosis (GUTB) is a chronic infection affecting the genitourinary tract.
- Miliary tuberculosis typically presents with widespread dissemination, but can manifest atypically within the genitourinary system.
Observation:
- A 15-year-old female presented with severe abdominal pain, dysuria, pyuria, and hematuria.
- Initial ultrasound was inconclusive; CT revealed a necrotic right kidney lesion.
- Acid-fast bacilli were identified in urine samples.
Findings:
- The patient was diagnosed with genitourinary tuberculosis presenting as miliary tuberculosis.
- Treatment with anti-tuberculosis therapy was initiated.
- Post-treatment imaging confirmed renal parenchymal injury.
Implications:
- This case highlights the importance of considering GUTB in the differential diagnosis of abdominal pain, voiding symptoms, sterile pyuria, and hematuria.
- Prompt diagnosis and treatment are essential to prevent complications and manage renal injury.
- Unusual presentations of GUTB require a high index of suspicion and comprehensive diagnostic workup.
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