A rare presentation of urogenital tuberculosis leading to obstructive uropathy and renal failure: a case report

BACKGROUND: Urogenital tuberculosis (UGTB) is a rare form of extrapulmonary tuberculosis (EPTB) affecting the kidneys, ureters, and bladder. Its nonspecific symptoms often mimic common urological conditions like urinary tract infections (UTIs), leading to delayed diagnosis. This case highlights the diagnostic challenges and emphasizes the need for timely intervention to prevent irreversible renal damage. CASE PRESENTATION: A 43-year-old south-Asian female presented with sudden decreased consciousness and severe renal impairment, requiring emergency dialysis. Despite the absence of typical tuberculosis symptoms or risk factors, imaging revealed obstructive uropathy with hydronephrosis. Urine polymerase chain reaction (PCR) confirmed UGTB. Early interventions, including percutaneous nephrostomy, J-stent placement, and anti-tuberculosis therapy (ATT), resulted in significant clinical improvement. CONCLUSIONS: UGTB should be considered in patients with unexplained urological conditions, particularly in tuberculosis-endemic regions. Early diagnosis and management are crucial to avoid irreversible complications and improve outcomes.