Renal tuberculosis in the urogynecologic patient: A case report

Abstract

Tuberculosis remains a global public health threat, with pulmonary presentation being the most common. Thus, extra-pulmonary sites can often go unrecognized in non-endemic regions. As global migration rises, urogenital tuberculosis is a condition to be recognized, especially in urogynecology populations. A post-menopausal woman presented to the urogynecology office with lower urinary tract symptoms. Routine urinalysis revealed persistent sterile pyuria and microhematuria. A computed-tomographic urogram demonstrated features suggestive of a chronic infectious inflammatory process. The patient’s urine was then tested for acid fast bacilli which was positive, and then referred to the infectious disease and renal specialists for co-management. She was treated with anti-tubercular drugs for a total of nine months, after which she made a complete recovery. Urogynecology clinics are environments where urine sample collection and testing are almost ubiquitous. Hence, sterile pyuria, a potential indicator for extra-pulmonary urogenital tuberculosis, should not be overlooked when identified, especially in patients from tuberculosis endemic countries.