Haematuria as an initial presentation of urinary bladder tuberculosis: A rare case report

• Author Details:   
• Jyoti Bajpai
• Shubham Shukla
• Surya Kant ^*
• Ajay Kumar Verma
• Manoj Kumar

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We present the case of a 35-year-old gentleman who had intermittent haematuria and dysuria for six months. The patient did not present with any constitutional signs, such as fever or weight loss, even though she was known to have hypothyroidism. Early imaging tests, such as non-contrast CT and ultrasonography, showed thickening at the vesicoureteral junction and mild hydroureteronephrosis, which may indicate an obstructive process. The diagnostic procedure was complicated by the presence of considerable haematuria in the urine, but a sterile urine culture and negative results from tests for acid-fast bacilli. A biopsy demonstrated granulomatous inflammation, which is consistent with tuberculosis, and cystoscopy revealed erythematous and inflammatory regions at the bladder trigone. These results led to the diagnosis of urinary bladder tuberculosis (TB), an uncommon but dangerous kind of extrapulmonary tuberculosis, in the patient. After starting treatment for extrapulmonary tuberculosis (TB) in accordance with the National Tuberculosis Elimination Program (NTEP) recommendations, the patient has improved with anti-tubercular medication. This case highlights the difficulties in diagnosing genitourinary tuberculosis, especially when common techniques like urine microscopy and culture are unable to identify the illness. The diagnosis was confirmed with the use of cystoscopy-guided biopsy, which allowed for prompt treatment and underlined the significance of a comprehensive clinical evaluation in patients of suspected UG-TB.

Keywords: Urinary bladder tuberculosis, Haematuria, Extrapulmonary Tuberculosis, Hydroureteronephrosis