Bladder Tuberculosis Can Mimic IC/BPS

One of the questions we always ask patients who contact the ICN for assistance is to ask if they were traveling prior to the onset of their symptoms. Why? Because certain diseases can be contracted while traveling. Case in point: Tuberculosis (TB), a deadly infection that most often infects the lungs but can also spread to the urinary tract where it can cause urinary frequency, urgency, pain and blood in the urine.

A new IC/BPS study in Korea looked at the medical record of 646 IC patients who had a cystoscopy seeking to identify diseases which could be confused with IC/BPS. Fourteen were found to have visible bladder cancer, which is strongly associated with smoking. Seven were found to have urinary tuberculosis, a condition that is rarer in the USA but still diagnosed every year throughout our country. (1)

Tuberculosis Around The World

According to the World Health Organization, TB infects 10 million people every year and 1.5 million die. TB is present in all countries and age groups. Half of those infections are found in Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines and South America.(2)

Tuberculosis is found in much smaller numbers in the USA yet thousands are diagnosed annually. In fact, the number of TB cases have been steadily increasing since 2020 with almost ten thousand cases diagnosed in the USA in 2023.(3) California had the highest number of TB cases (2113), while Texas (1,100) New York (709), Florida (535) and Illinois (298) rounded out the top five states. Most other states are also finding small numbers of TB cases each year.

Tuberculosis Symptoms & Diagnosis

Common symptoms of TB include: a prolonged, sometimes bloody, cough, chest pain, weakness, fatigue, weight loss, fever and night sweats. Other risk factors include diabetes, immune system suppression, malnourishment, alcoholism and tobacco use. Symptoms can also present very mildly which leads to patients spreading it to others without knowing it. It can also remain inactive into the body but can become active if a patient develops immune system suppression disorder, such as HIV or AIDS.

In 5 to 45% of TB patients, tuberculosis can spread throughout the body including the urinary tract where it can damage both the kidneys and bladder. (4) These symptoms are very reminiscent of interstitial cystitis including urinary frequency, pain and blood in the urine.

Diagnosis is made via culturing urine, blood, fluid from the prostate and, of course, biopsies. Treatment is usually an extended period of antibiotics (rifampicin ethambutol, isoniazid purazinamide), usually six months. Surgery may be needed if there is a blockage in the ureters or if there is significant damage to the kidneys. The cure rate, thankfully is around 90%. There is, however, a very drug resistant strain of TB circulating. These infections may require more expensive and potentially toxic treatments.

Conclusion

Why does California, Texas and Florida have higher rates of TB? Undoubtedly, it’s from tourists who are visiting and/or from residents who are traveling abroad for vacations or work. Even a simple trip to Mexico could increase your exposure to TB. Mexico is considered a “moderate-incidence” country for TB infection.

If your urinary symptoms began during or after a trip abroad to Southeast Asia, Africa and the Western Pacific, please mention your travels to your physician. It may be appropriate to do a diagnostic workup for TB just to be on the safe side.

References:

Ju Jeong, H. et al. Excluding confusable diseases in patients with presumptive diagnosis of interstitial cystitis: A large patient cohort study. Gynaecol Obstet. 2024 Aug 11. https://pubmed.ncbi.nlm.nih.gov/39127911/
World Health Organization. Tuberculosis Fact Sheet. November 7, 2023 – https://www.who.int/news-room/fact-sheets/detail/tuberculosis
Williams P, et al. Tuberculosis – United States 2023. MMWR Morb Mortal Wkly Rep. 2024 Mar 28; 73(12):265-270 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10986816/
West, Mary. What to know about genitourinary tuberculosis. MedicalNewsToday. January 23, 2024. https://www.medicalnewstoday.com/articles/genitourinary-tuberculosis

By Jill Osborne|2024-08-27T11:00:07-07:00August 15th, 2024|Latest Research, Our Blog|Comments Off

About the Author: Jill Osborne

My Google Profile+ Jill Heidi Osborne is the president and founder of the Interstitial Cystitis Network, a health education company dedicated to interstitial cystitis, bladder pain syndrome and other pelvic pain disorders. As the editor and lead author of the ICN and the IC Optimist magazine, Jill is proud of the academic recognition that her website has achieved. The University of London rated the ICN as the top IC website for accuracy, credibility, readability and quality. (Int Urogynecol J - April 2013). Harvard Medical School rated both Medscape and the ICN as the top two websites dedicated to IC. (Urology - Sept 11). For many years, Jill served on the Congressionally Directed Medical Research Panel (US Army) where she collaborated with researchers to evaluate new IC research studies for possible funding. Jill has conducted and/or collaborates on a variety of IC research studies on new therapeutics, pain care, sexuality, the use of medical marijuana, menopause and the cost of treatments, shining a light on issues that influence patient quality of life. An IC support group leader and national spokesperson for the past 20 years, she has represented the IC community on radio, TV shows, at medical conferences. She has written hundreds of articles on IC and its related conditions. Jill has a Bachelors Degree in Pharmacology and a Masters in Psychology, Jill was named Presidential Management Intern (aka Fellowship) while in graduate school. (She was unable to earn her PhD due to the onset of her IC.) She spends the majority of her time providing WELLNESS COACHING for patients in need and developing new, internet based educational and support tools for IC patients, including new live IC Support Group Meetings via Youtube and the “Living with IC” video series. Jill was diagnosed with IC at the age of 32 but first showed symptoms at the age of 12.