title: Think global, act local: chronic dysuria and sterile pyuria in an Eritrean-American woman.
abstract: A 70-year-old female Eritrean immigrant living in the USA presented with classic findings of genitourinary (GU) tuberculosis (TB), including risk of tuberculosis exposure based on country of origin, chronic urinary tract symptoms and persistent sterile pyuria despite antibacterial therapy. Furthermore, this patient had the hallmark radiographical findings of ureteral stricture, a dilated pelvic calyceal system, hydroureteronephrosis and bladder wall thickening, as well as a bladder wall biopsy that revealed granulomatous disease. The patient was evaluated multiple times over the course of 3 years in outpatient and inpatient medical settings before a diagnosis was made and appropriate treatment initiated. As with many cases of GU TB, a protracted diagnosis allowed for advanced disease progression and significant morbidity from obstructive uropathy and chronic kidney disease.
authors: Department of Medicine, University of California San Francisco, San Francisco, California, USA.
authors: Rachel Lena
authors: RL
authors: Rutishauser
authors: Charles
authors: C
authors: Langelier
authors: Sanjiv M
authors: SM
authors: Baxi
authors: Douglas
authors: D
authors: Hanks
authors: Peter
authors: P
authors: Chin-Hong
mesh_terms: D000368:Aged; D057210:Delayed Diagnosis; D053159:Dysuria / Q000209:etiology; D054242:Emigrants and Immigrants; D019017:Eritrea / Q000208:ethnology; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D011776:Pyuria / Q000209:etiology; D014401:Tuberculosis, Urogenital / Q000150:complications / Q000175:diagnosis*; D014481:United States; D014517:Ureteral Obstruction / Q000209:etiology