Case Study - December 2013

This 48 year old patient had haematuria and some dysuria. Investigations revealed red patches in the bladder and this image. Bladder biopsies revealed granulomatous lesions in the bladder.  

1. What does this CT show?

2. What is the likely diagnosis?

3. What are other tests would you undertake?

4. What is the treatment?

Reveal Answer

1. The CT scan shows left hydroureteronephrosis and abnormal thickened dilated ureter.

2. The likely diagnosis is urinary tract TB.

3. This patient underwent imaging of her chest, early morning urine samples and a Quanteferon test.

4. This patient was treated with Rifampicin, Isoniazid, Pyrizinamide and Ethambutol. Her bladder appearance improved on cystoscopy as did her urinary symptoms. She will still require on going urological management of her abnormal ureter.

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