Delayed diagnosis of urinary tuberculosis.

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Date: Feb. 28, 2022
Publisher: CMA Impact Inc.
Document Type: Clinical report
Length: 683 words
Lexile Measure: 1450L

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A 37-year-old man, who had immigrated from Romania 4 years prior, presented to the emergency department after several months of frequent urination and right-sided lumbar pain. Urine microscopy showed leukocytosis and hematuria. His urine bacterial culture was negative and renal function was normal. An abdominal computed tomography (CT) scan showed right kidney abscesses and thickening of the bladder and urethral walls (Figure 1A). He received a diagnosis of complicated upper urinary tract infection (UTI), and was treated with levofloxacin.

Six months later, the patient presented again with similar symptoms. Repeat urine culture was negative and he was empirically treated with trimethoprimsulfamethoxazole. One year after initial presentation, the patient still had urinary tract symptoms. Upon receiving a CT scan for a dental abscess, he was found to have apical pulmonary micronodules with centrolobular distribution.

Given the low prevalence of UTIs in young men, and the patient's chronic sterile pyuria, failure to respond to antibiotics and pulmonary findings on CT, we suspected genito-urinary tract tuberculosis. He was referred to our infectious disease...

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Gale Document Number: GALE|A694380455