Chyluria: A rare initial manifestation of disseminated tuberculosis

Chyluria is described as passage of chyle in the urine. It results from the formation of lymphaticorenal fistulae due to various etiologies. The most common implicated cause is filariasis especially in endemic areas. Other uncommon causes include thoracic duct trauma or anatomical abnormalities, pregnancy, malignancy, and tuberculosis. Although tuberculosis has been included as a cause, there are only a few case reports suggesting it as an etiology. Tuberculosis can present in various ways. However, chyluria as initial presentation of tuberculosis has never been reported in the literature. We present, here, an extremely rare case of disseminated tuberculosis involving lung, lymph nodes, liver, intestine, and spine presenting as chyluria. The patient responded dramatically with antituberculous therapy with complete clearing of urine.