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BMJ Case Rep. 2017 Oct 15;2017. pii: bcr-2017-221270. doi: 10.1136/bcr-2017-221270.

Obstructive uropathy as initial presentation of genitourinary tuberculosis and masquerading as a postsurgical complication.

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Nephrology unit, Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda.
Urology Unit, Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda.
Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda.
Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.


A 46-year-old woman who had a recent total abdominal hysterectomy presented with a 1 month history of lower abdominal pain, 1 week of nausea and vomiting as well as decreased urinary output preceded by a year of significant unintentional weight loss. On renal imaging, she was found to have bilateral hydronephrosis and hydroureters in the setting of bilateral distal ureteric obstruction complicated with acute kidney injury and severe hyperkalaemia requiring haemodialysis. The initial concern was for ureteric injury, a known complication of abdominal hysterectomy procedures, however, a urological intervention, performed 9 months later to relieve the ureteric obstruction, revealed purulent material within the left ureter that was smear positive for acid fast bacilli. A GeneXpert test was positive for Mycobacterium tuberculosis She was diagnosed with genitourinary tuberculosis and responded well to antitubercular treatment and haemodialysis was discontinued after the surgery relieved her ureteric obstruction.


Tb and other respiratory infections; global health; urinary tract infections

[Indexed for MEDLINE]

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