A 45-year-old woman with long-standing hypertension and premature menopause presented with progressive bilateral pitting leg edema. Initial evaluation showed albuminuria, microscopic hematuria and pyuria, severe mixed dyslipidemia, and prediabetes. Despite optimization of blood pressure and cardiometabolic therapy, edema progressed to the thighs, and urinary protein excretion increased. Renal ultrasonography showed increased parenchymal echogenicity, with scarring of the lower half of the left kidney. Subsequent evaluation revealed hypoalbuminemia and nephrotic-range proteinuria of 8.64 g/day. Autoimmune and viral hepatitis screening was negative, and a right renal biopsy confirmed minimal change disease (MCD)/podocytopathy. Treatment with prednisolone 60 mg/day and diuretic therapy led to rapid clinical remission, with complete resolution of edema and reduction of 24-hour urinary protein to 190 mg/day by May 2025 and 55 mg/day by July 2025. The course was complicated by steroid-induced Cushingoid features and worsening glycemia, requiring temporary addition of glimepiride. By March 2026, the patient remained clinically well with excellent lipid and glycemic control. This case highlights the importance of early nephrology referral and kidney biopsy in adults with progressive albuminuria and edema, even when cardiometabolic comorbidities such as hypertension, prediabetes, and severe dyslipidemia coexist.

Jackstone calculus is a rare urinary stone morphology with a distinctive spiculated appearance, most often reported in the bladder and usually associated with urinary stasis or outlet obstruction. We report a 70-year-old man with 1 year of progressive dysuria and intermittent interruption of urinary stream despite tamsulosin and finasteride. Urinalysis showed pyuria, hematuria, and bacteriuria. Ultrasonography and pelvic computed tomography identified an irregular star-shaped bladder stone and marked prostatic enlargement, with an estimated prostate volume of approximately 125 mL on ultrasonography. Serum total prostate-specific antigen was 16.2 ng/mL, with a free-to-total ratio of 0.138. Systematic transrectal biopsy showed adenocarcinoma in 2 of 12 cores, Gleason score 3 + 3 = 6 (Grade Group 1). After multidisciplinary discussion, the patient underwent laparoscopic radical prostatectomy with concomitant intact stone removal. The 3.1-cm stone showed classic jackstone morphology. Final pathology showed Gleason 3 + 4 = 7 adenocarcinoma (Grade Group 2), upgraded from biopsy, with negative surgical margins. Telephone follow-up at 1, 3, and 12 months showed sustained improvement of lower urinary tract symptoms without recurrent urinary tract infection-related symptoms. Postoperative imaging and prostate-specific antigen data were unavailable. This case is relevant to men's health because a visually distinctive bladder stone may coexist with clinically relevant prostatic disease. In men with lower urinary tract symptoms and abnormal prostate-specific antigen values, bladder outlet obstruction, infection, or bladder stones should not preclude further oncologic evaluation. In selected patients in whom definitive prostate surgery is chosen, combined stone removal can be a practical single-stage approach.

Extrapulmonary tuberculosis often presents diagnostic challenges due to its involvement in multiple organ systems. We report a case of a 54-year-old, immunocompetent man who presented with prolonged fever and a generalized seizure. Neuroimaging revealed ring-enhancing lesions suggestive of tuberculomas. Further evaluation demonstrated a seminal vesicle abscess and cervical lymphadenitis. Histopathology and microbiological analysis confirmed Tuberculosis. The patient was initiated on antitubercular therapy, along with anti-convulsants and steroids. This case highlights the importance of considering EPTB in patients with sterile pyuria, neurological symptoms, even in immunocompetent individuals without a pulmonary disease.

In addition to the culture methods perfomed in commercial laboratories, point-of-care tests (POC tests) are available for the assessment of bacteriuria in dogs and cats. This article provides an overview of the POC tests currently used to detect bacteriuria in veterinary medicine. Manual urine sediment analysis is a cost-effective method for the detection of bacteria, but there is no clear standardization. Devices for automated urine sediment analysis require visual follow-up by the user, which is essential to correctly identify bacteria. RapidBacVet, a lateral flow immunoassay, enables rapid detection of bacteria in the urine - but without the possibility of differentiation. Culture tests allow bacteria to be grown and tested for sensitivity to antibiotics. However, these methods are limited in cases of mixed infections or specific resistance testing. A chromogenic culture test such as UTid+provides rapid diagnosis of bacteriuria, but does not allow for the quantification of bacterial growth. Accutest Uriscreen, a catalase-based rapid test, detects bacteriuria and pyuria with high sensitivity, but requires a large sample volume of urine. This article highlights the strengths and weaknesses of each POC test and describes how these may contribute to more efficient diagnostics and improved treatment selection in small animal practice.