Genitourinary tuberculosis presenting as treatment resistant dysuria in a young patient: a case report

Genitourinary tuberculosis is the second most common form of extrapulmonary tuberculosis. We present the case of a male patient in his late 20s who presented to his general practitioner with symptoms of recurrent urinary tract infection (UTI). Upon investigation his estimated glomerular filtration rate was found to be 61 ml/min/1.75 m² and an ultrasound scan of the kidney, ureters, and bladder revealed a left sided hydronephrosis. A computerized tomography urogram confirmed upper and lower pole lesions of the left kidney with ureteric changes and lymphadenopathy consistent with chronic atypical infection. A urine acid-fast bacilli culture was positive for urinary tuberculosis (TB). The patient's disseminated TB was treated with conventional anti-TB medications. Our case report highlights the value in considering genitourinary tuberculosis amongst the list of differential diagnoses in younger patients presenting with symptoms of recurrent UTI.