Chonnam Med J.  2013 Apr;49(1):48-49. 10.4068/cmj.2013.49.1.48.

Gross Hematuria Associated with Genitourinary Tuberculosis

• Bae EH
• Heo S
• Kim YH
• Hwang IS
• Choi JS
• Kim CS
• Ma SK
• Kim SW

• KMID: 2172177
• DOI: http://doi.org/10.4068/cmj.2013.49.1.48

Abstract

A 27-year-old man presented to the emergency department with sudden onset of massive gross hematuria and urinary retention. Contrast-enhanced computed tomography imaging showed uneven, dilated calices and a narrowing of the renal pelvis in the left kidney; in addition, a large hematoma was noted in the urinary bladder. An emergency cystoscopy was performed following detection of the hematoma and blood clots were removed. A lesional biopsy, a tuberculosis (TB) culture, and urine cytology showed positive results for Mycobacterium tuberculosis. The clinical manifestations of genitourinary tuberculosis are nonspecific and are usually detected at a chronic stage. In conclusion, we report an unusual cause of acute kidney injury associated with a subacute stage of genitourinary tuberculosis that caused mucosal erosion and bleeding in the bladder.

Keyword

Tuberculosis; Acute kidney injury; Hematuria

MeSH Terms

Acute Kidney Injury
Biopsy
Cystoscopy
Emergencies
Hematoma
Hematuria
Hemorrhage
Kidney Pelvis
Mycobacterium tuberculosis
Tuberculosis
Urinary Bladder
Urinary Retention

Figure

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  FIG. 1 (A) Contrast-enhanced excretory-phase computed tomography image showing uneven dilated calices (arrows) and narrowing of the renal pelvis (arrowhead) of the left kidney and a large hematoma in the urinary bladder. (B) Computed tomography with intravenous pyelogram image showing an invisible left pyelonephrogram compared with a normal right pyelonephrogram.

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  FIG. 2 Polymerase chain reaction for urine showed a positive result for Mycobacterium tuberculosis.

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  FIG. 3 Hematoxylin and eosin staining in the bladder showed caseous necrosis and inflammatory cell infiltration (×200).

Reference

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