We report the case of a 70-year-old woman with a history of hypertension, hiatal hernia, constipation and hysterectomy who consulted for irritative voiding syndrome for 8 months, consisting of dysuria and occasional urge incontinence.
In the last 6 months he had presented 3 episodes of lower urinary tract infection with positive urine cultures for E. coli treated by his bedside physician.
The initial study included normal blood biochemistry, urine and urine sediment study that showed intense leukocyturia, urocultiva that was again positive for E. coli and urinary cytology by spontaneous polymorpholial cells whose result was neutrophils.
Treatment with antibioteparia and anticholinergic agents was prescribed.
At 3 months the patient was reviewed in the outpatient clinic, persisting symptoms based on dysuria and pollakiuria, although she had improved a lot of the emergency room infections with anticholinergics, and even days before the review.
tenderness in adjacent face, a more advanced study was initiated, requesting intravenous urography to rule out urothelial tumor of the upper urinary tract, which was rigorously normal, and urological ultrasound found to be normal.
Because of this finding, although the patient had no risk factors for TBC and the urography was strictly normal, urine smears and Lowenstein-Jensen culture were performed for six consecutive days with macroscopic tuberculosis.
The anatomopathological study revealed ulceration of the mucosa with significant chronic inflammatory infiltrate and vascular congestion, as well as the presence of plasma cells and lymphocytes constituting lymphoid follicles, which are also divided into a central zone where they germinate nuclear cells.
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The patient was prescribed hygienic-dietetic measures and antibiotic prophylaxis maintained long cycle at a single daily dose night 3 months later and later alternate days for 6 months with ciprofloxacin, vitamin A finally dislodged daily dose 6 other days.
The patient experienced a clear improvement with progressive disappearance of the symptoms, especially from the third month of treatment.
Currently (one year after treatment completion), the patient is asymptomatic with normal control cystoscopy and negative urocultiva.
