Navigating genitourinary tuberculosis: lessons from a 2023 case

Abstract Background: Genitourinary tuberculosis (GU-TB), an extrapulmonary manifestation of Mycobacterium tuberculosis (Mtb) infection, often presents insidiously, posing diagnostic challenges and leading to progressive tissue destruction, chronic kidney disease, and urogenital dysfunction. Case presentation: We report a case of a patient initially diagnosed with endometriosis due to dysmenorrhea and chronic pelvic pain. Despite multiple surgical interventions, symptoms worsened. Misdiagnoses of urinary infections resulted in ineffective treatments. Subsequent testing revealed Mtb, prompting a six-month regimen of four-drug therapy (2HRZE/4HR), leading to significant improvement. Conclusion – take away lesson(s): This case underscores the importance of considering GU-TB in patients with persistent urogenital symptoms, even with initial negative tests. It emphasizes the necessity of a multidisciplinary approach and consideration of uncommon conditions for successful outcomes in complex scenarios.