[Genitourinary mycobacteriosis: retrospective study of 45 cases in a general hospital].
BACKGROUND
Genitourinary tuberculosis (GUT) is the third most frequent extrapulmonary tuberculous infection, following pleural and nodal involvement. Associated clinical symptoms are mild, and the diagnosis and treatment of this condition are often delayed.


METHODS
This study determines the clinical and epidemiological characteristics, and outcome of patients diagnosed with GUT in our center over the last 10 years. Patients with positive Löwenstein-Jensen urine or biopsy culture, or pathologic study suggestive of tuberculosis were included. Cases of multifocal tuberculosis and positive Löwenstein-Jensen, but with no urinary symptoms or radiological alterations, were considered to have mycobacteriuria.


RESULTS
Forty-five patients were analyzed (62% men; mean age, 49.4 years). Among the total, 33% had a coexisting disease (14 were infected by human immunodeficiency virus). Twenty-six patients (57%) had renal tuberculosis, 5 (11%) orchiepididymitis, and 14 (31%) were classified as having mycobacteriuria. The most frequent clinical manifestations were urination syndrome (61%), low back pain (44%), and macroscopic hematuria (12%). Ziehl stain was positive in 38% cases. Urine culture was positive for other microorganisms in 9 patients (20%). Intravenous urography oriented the diagnosis in 87.5% of cases. The average interval between onset of symptoms and diagnosis was 15 months. Cure without sequelae was obtained in 60%. Surgery was indicated in 10 patients.


CONCLUSIONS
The index of suspicion for GUT should be high when patients present with repeated urinary syndromes. The current use of imaging studies other than urography and the finding of other microorganisms in urine culture can delay the diagnosis.
Navarro-Vilasaró
Marta
M
Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain. mnavarro@tauli.cat
Font
Bernat
B
Sala
Montserrat
M
Prera
Antoni
A
Malet
Antoni
A
Mariscal
Dolors
D
Segura
Ferran
F
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D001437:Bacteriuria / Q000188:drug therapy / Q000382:microbiology; D003131:Combined Modality Therapy; D015897:Comorbidity; D004823:Epididymitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006417:Hematuria / Q000209:etiology; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D011472:Prostatitis / Q000188:drug therapy / Q000209:etiology; D011704:Pyelonephritis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014401:Tuberculosis, Urogenital / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D014555:Urination Disorders / Q000209:etiology
D000995:Antitubercular Agents