Approximately 30% of the world population presents with tuberculosis. In developed countries, genitourinary manifestation is responsible for over 40% of extrapulmonary cases. Genitourinary tuberculosis is often diagnosed in the later stage due to the fact that the symptoms are non-specific and technical difficulties to isolate the tubercle bacillus through bacilloscopy or culture in specific medium are many. We present a case of a 47-year-old African-American woman with relapsing urinary infection and sterile pyuria. After a 4 four-year evolution, the patient developed functional exclusion of the right kidney as a consequence of chronic pyelonephritis. The investigation result for alcohol-acid bacillus resistant in urine was positive along with the culture for Mycobacterium tuberculosis.
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