Abstract summary 

In January 2017, the World Health Organisation recommended the Xpert MTB/RIF Ultra assay (Ultra) for tuberculosis (TB) diagnosis. Ultra offers improved analytical sensitivity when compared with the initial Xpert MTB/RIF (Xpert) assay for the detection of Mycobacterium tuberculosis. Ultra is therefore likely to be of particular benefit for detecting paucibacillary TB. We present a case from Uganda demonstrating Ultra positivity in urine from an HIV-infected patient presenting with altered mental status and urinary incontinence, and no other signs of active pulmonary or extrapulmonary TB. This represents the first published instance of a diagnosis of extrapulmonary TB made on the basis of a positive urine Ultra assay. The use of Ultra on urine may be a useful addition to the diagnostic armamentarium for disseminated TB in persons with HIV co-infection. The diagnostic accuracy of urine Ultra should be characterised further via prospective studies.

Authors & Co-authors:  Atherton Rachel R RR Cresswell Fiona V FV Ellis Jayne J Skipper Caleb C Tadeo Kiiza K KK Mugumya Gerald G Wadda Vincent V Meya David B DB Boulware David R DR

Study Outcome 

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