CASE REPORT: UROGENITAL TUBERCULOSIS PRESENTING AS IGA NEPHROPATHY AND RECURRENT CULTURE- NEGATIVE URINARY TRACT INFECTIONS

Kon Ken Wong1, Chuan Hun Ding1, Zaili Zaki1, Najihan Abdul Samat Muttaqillah1, Yin Ping Wong2 and Ping Foo Wong3

Abstract

Tuberculosis is a public health problem that can cause extrapulmonary infections, including urogenital infections. We report here the case of a 29-year-old female with a 2-year history of dysuria and hematuria treated with multiple courses of antibiotics with urine cultures all negative. She was then diagnosed with IgA nephropathy based on a renal biopsy showing focal segmental glomeru-losclerosis and mesangial IgA deposits without granulomata. A polymerase chain reaction (PCR) for urinary tuberculosis was positive for Mycobacterium tuberculosis complex. A chest radiograph was normal. The patient was treated with isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months, followed by isoniazid and rifampicin for an additional 4 months. The patient responded well to treat-ment and her symptoms resolved completely. Urogenital tuberculosis should be considered in the patient who presents with dysuria and hematuria whose symptoms fail to improve with routine antimicrobials and who has a routine a urine cultures failing to show infection.