594 Genitourinary Tuberculosis: An Unusual Presentation of Sepsis with Renal Colic in the UK

Abstract Introduction We highlight a rare case of a patient presenting with renal colic with concurrent sepsis which eventually led to the diagnosis of genitourinary tuberculosis. Case description A 37-year-old male presented to the hospital with a two-week history of right renal colic and fevers. Initial investigations were consistent with infection (CRP 91, WBC 14, HR 103, 39.1 C). A non-contrast CT Scan to exclude nephrolithiasis revealed an abnormal right renal tract with features suspicious of xanthogranulomatous pyelonephritis. A contrasted CT revealed dilated calyces but a non-dilated renal pelvis. In view of the clinical setting, a ureteric stent was inserted to ensure optimal drainage of the right kidney. Patient was booked for a diagnostic ureteroscopy as an outpatient. An interval CT Scan did not identify any improvement in the appearance of the Right kidney. Follow up investigations were thus prompted which eventually isolated Mycobacterium tuberculosis (specifically requested) from the urine cultures. The subsequent HRCT Thorax did not reveal any pulmonary disease. The patient was started on antimicrobial treatment for renal tuberculosis 3 months after initial presentation. The patient who has resided in the UK for the last 20 years denied any exposure to patients with TB. He travelled 5 months prior to his original presentation to the Philippines. Conclusions Genitourinary tuberculosis is a rare finding in the UK and can present with varied and subtle features. Urological units should be aware of the management of this condition, in view of an increasingly diverse populations/travel.