Diagnostic pitfalls of urogenital tuberculosis. Issue 7 (6th May 2021)

• Record Type: Journal Article
• Authors: Chandran, Shruthi; Rahman, Ananna; Norris, Joseph M.; Tiberi, Simon; Kunst, Heinke
• Is Part Of: Tropical medicine & international health. Volume 26:Issue 7(2021)
• Page Start: 753
• Page End: 759
• Publication Date: 2021-05-06
• Subjects: urogenital tuberculosis -- extra‐pulmonary tuberculosis -- tuberculosis diagnostics -- tuberculosis treatment; Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.13583
• Languages: English
• ISSNs: 1360-2276

Abstract

Abstract: Objectives: To describe characteristics, details of diagnosis and outcomes of urogenital tuberculosis (UGTB) in a low‐prevalence country. Methods: We conducted a retrospective observational study of 37 consecutive patients diagnosed with UGTB between 1 st January 2014 and 31 st October 2019 in an East London hospital. Results: 68% (25/37) of patients were male and the median age was 42 years (IQR 34–55). 89% (33/37) of patients were born outside the United Kingdom with 65% (24/37) born in the South Asian region. Renal (32.4%), epididymal (24.3%) and endometrial TB (21.6%) were the most prevalent forms of UGTB. Only 13.5% of UGTB patients had concurrent pulmonary TB. The median length of time from symptom onset to treatment was 163 days, while endometrial TB had an average delay to diagnosis of 564 days. Approximately half of patients with UGTB were culture positive (51.4%). However, 70% of early morning urines (EMUs) sent in urinary TB were culture positive. 11 patients (30.6%) underwent two or more invasive procedures, such as biopsy to obtain specimen samples. The mean treatment length for all UGTB cases was 7.3 months (SD 3.1). Notably, 25% of patients with endometrial TB required surgery despite antituberculous treatment. Conclusions: UGTB is challenging to diagnose as early disease is often asymptomatic. Clinicians faced with non‐specific symptoms, or features suggestive of urogenital malignancy amongst patients from TB‐endemic areas, should maintain a high suspicion of UGTB.