Mycobacterium gordonae is frequently isolated from urine, but M gordonae genitourinary disease is rare; the majority of the isolates are commensals. We describe a 40 year old housewife who presented with loin pain, dysuria and frequency. Urine contained excessive pus cells, was sterile on culture and she did not respond to broad spectrum antibiotics. There was repeated isolation of M gordonae from the urine and she responded to a standard antituberculosis regimen. She was irregular and non-compliant with supervised therapy and relapsed three months after stopping medications. She again had symptoms and M gordonae was repeatedly isolated from the urine, Mycobacterium tuberculosis and other pathogens were not isolated. There was no evidence of humoral or cellular immunodeficiency or HIV infection.
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