Genitourinary Tuberculosis With Renal and Bladder Involvement in a Patient With Wasting Syndrome and Hematuria

Genitourinary tuberculosis (GUTB) is an extrapulmonary form of Mycobacterium tuberculosis infection, often presenting with nonspecific clinical features and delayed diagnosis. We report the case of a 55-year-old man with chronic cough and a seven-month history of wasting syndrome, associated with dysuria and persistent hematuria. Imaging revealed bladder wall thickening and renal changes suggestive of GUTB. Cystoscopy identified an infiltrative bladder lesion, and rapid molecular testing detected M. tuberculosis in bladder tissue fragments and urine, despite negative smear microscopy. Confirmation of pulmonary tuberculosis characterized disseminated disease. The patient showed clinical improvement after initiation of standard RIPE therapy. This case highlights the importance of diagnostic suspicion of GUTB in patients with chronic urinary symptoms and systemic manifestations, as well as the fundamental role of molecular biology in early diagnosis and appropriate management of extrapulmonary tuberculosis.