Urogenital tuberculosis in a patient with persistent sterile pyuria

Area of Science:

• Infectious Diseases
• Nephrology
• Urology

Background:

• Urogenital tuberculosis (UGTB) poses diagnostic challenges, potentially leading to irreversible organ damage if treatment is delayed.
• Prompt diagnosis and management are essential for favorable outcomes in UGTB cases.

Purpose of the Study:

• To report a case of Urogenital Tuberculosis (UGTB) presenting with unusual symptoms.
• To highlight the importance of considering UGTB in patients with persistent sterile pyuria and relevant epidemiological factors.

Main Methods:

• Case report of a 40s Guinean man residing in Portugal.
• Clinical presentation: lower urinary tract symptoms, urethral discharge, scrotal mass.
• Diagnostic workup included laboratory tests (kidney function, calcium, urinalysis), ultrasound, Interferon gamma release assay, and urine cultures for Mycobacterium tuberculosis.

Main Results:

• The patient presented with acute kidney injury, hypercalcaemia, and persistent sterile pyuria.
• Ultrasound suggested orchiepididymitis; Interferon gamma release assay and urine cultures confirmed Mycobacterium tuberculosis.
• The patient responded favorably to tuberculostatic drugs.

Conclusions:

• UGTB diagnosis requires a high degree of clinical suspicion.
• Persistent sterile pyuria in the context of relevant epidemiology warrants consideration for UGTB.
• Early diagnosis and treatment are vital to prevent organ damage.