Acta Scientific Microbiology (ISSN: 2581-3226)

Review Article Volume 5 Issue 2

Clinical, and Diagnostic Characteristics of an Unsuspected Course of Urinary Tuberculosis: A Brief Report

Gloria G Guerrero1*, Luis A Aguilera-Galaviz2, Arturo Araujo-Conejo3, Iskra Tuero4 and Juan Manuel Favela-Hernández5,6

Guerrero GG1*, Aguilera-Galaviz LA2, Araujo-Conejo A3, Tuero I4 and Favela-Hernández JM5,6

1Universidad Autónoma de Zacatecas, Unidad Académica de Ciencias Biológicas, Zacatecas, Zac, México
2Universidad Autónoma de Zacatecas Unidad Académica de Odontología, Programa de Licenciatura de Médico Cirujano Dentista, Especialidad en Odontopediatría y Maestría en Ciencias Biomédicas. Zacatecas, Zac, México
3Hospital General de Zacatecas, Departamento de Investigación de los Servicios de Salud (SSZ), Ciudad Gobierno, Zacatecas, Zac, México
4Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima-Perú
5Universidad Juárez del Estado de Durango, Facultad de Ciencias Químicas, Gómez, Palacio, Dgo, México
6Instituto Multidisciplinario de Ciencias AVICENA, Campus Torreón, Torreón, Coahuila, México

*Corresponding Author: Gloria G Guerrero, Universidad Autónoma de Zacatecas, Unidad Académica de Ciencias Biológicas, Zacatecas, Zac, Méxi.

Received: December 17, 2021; Published: January 21, 2022


Human Tuberculosis caused by Mycobacterium tuberculosis (MTb) remains a serious public health problem because of the high percentage of asymptomatic infection. Even worse, from this percentage, around 20% develop disseminated Tuberculosis involving the urinary tract. How to approach this?. A key issue is the accuracy and speediness of the diagnosis. In the present brief report, we described and pinpointed an unsuspected course of urinary Tuberculosis in an individual that presented signs not very characteristic of non pulmonary TB. The main symptoms were microhematuria, urinary incontinence, and urinary infections. To gain insight into the characterization of the clinical manifestations of the infectious disease, we pursued unconventional analysis assays, along with classic microbiological media tools. Molecular (microarrays, pattern of biomarkers) and serological reactivity (mycobacterial antigens detection) were determined in both blood and exudates. Remarkably, in the urinary diagnosis of Tuberculosis, these alternative tools could provide strong support and input to the clinics, especially in unsuspected cases.

Keywords:Urinary Tuberculosis; Hematuria; Urinary Contingency; BAAR; PCR; RT-PCR; Microarrays; Serological Reactivity


  1. World Health Organization (WHO). “Global Tuberculosis control; surveillance, planning financing”. WHO/HTM/TB/2008.393. Geneva, Switzerland: WHO (2010a).
  2. World Health Organization (WHO). “Treatment of Tuberculosis: Guidelines”. 4th WHO (online) (2010b).
  3. Maher D and Raviglione M. “Global epidemiology of Tuberculosis”. Clinics in Chest Medicine 26 (2005): 167-182.
  4. Hershberg R., et al. “High functional diversity in M. tuberculosis driven by the genetic drift and human demography”. PloS Biology 6 (2008): e311.
  5. Young DB., et al. “Confronting the scientific obstacle to global control of Tuberculosis”. Journal of Clinical Investigation 118 (2008): 1255-126.
  6. Rodríguez LC., et al. “Protective effect of BCG against Meningitis and Miliary Tuberculosis: a Meta-analysis”. International Journal of Epidemiology 22 (1993): 1154-1158.
  7. Fine PEM. “Variation in protection by BCG: implications of and for heterologous immunity”. Lancet 346 (1995): 1339-1345.
  8. Herrera V., et al. “Clinical application and limitations of interferon-gamma release assays for the diagnosis of latent tuberculosis infection”. Clinical Infectious Diseases 52 (2011): 1031-1037.
  9. Abebe F. “Is Interferon-gamma the right marker for Bacille Calmette-Guerin-induced immune protection? The missing link in our understanding of tuberculosis”. Clinical and Experimental Immunology 169 (2012): 213-219.
  10. Koul A., et al. “Interplay between mycobacteria and host signaling pathways”. Nature Reviews Microbiology 2 (2004): 189-202.
  11. Pulendran B and Ahmed R. “Translating innate immunity not immunological memory: implications for vaccine development”. Cell 124 (2006): 849-863.
  12. Mohr I and Sonenberg N. “Host translation of the nexus of infection and immunity”. Cell Host Microbe 12 (2012): 470-483.
  13. “Guidelines for the treatment of drug-susceptible tuberculosis and patient care” (2017).
  14. “WHO Global Tuberculosis report 2018” (2018).
  15. “The top 10 causes of death” (2019).
  16. Wise GJ. “Urinary tuberculosis: modern issues”. Current Urology Reports 10 (2009): 313-318.
  17. Figueiredo AA., et al. “Epidemiology of urogenital tuberculosis worldwide”. International Journal of Urology 15 (2008): 827-832.
  18. Abbara A., et al. “Etiology and management of genitourinary tuberculosis”. Nature Reviews Urology 8 (2011): 678-688.
  19. Floyd K., et al. “The global tuberculosis epidemic and progress in care, prevention, and research: an overview in year 3 of the End TB Was”. Lancet Respiratory Medicine 6 (2018): 299-314.
  20. Wise GJ and Shteynshlyuger A. “An update on lower urinary tract tuberculosis”. Current Urology Report 9 (2008): 305-313.
  21. Adhikari S and Basnyat B. “Extrapulmonary tuberculosis: a debilitating and often neglected public health problem”. BMJ Case Report 11 (2018): e226098.
  22. Yadav S., et al. “Genital tuberculosis: current status of diagnosis and management”. Translational Andrology and Urology 6 (2017): 222-233.
  23. Munner A., et al. “Urogenital tuberculosis - epidemiology, pathogenesis and clinical features”. Nature Reviews Urology10 (2019): 573-559.
  24. Kulchavenya E., et al. “Urogenital tuberculosis: classification, diagnosis, and treatment”. European Urology 15 (2016): 112-121.
  25. Liu HY., et al. “Tuberculous epididymitis: a case report and literature review”. Asian Journal of Andrology 7 (2005): 329-332.
  26. Mert A., et al. “Urinary tuberculosis: still a challenge”. World Journal of Urology 38 (2020): 2693-2698.
  27. McNerney R and Zumla A. “Impact of the Xpert MTB/ RIF diagnostic test for tuberculosis in countries with a high burden of disease”. Current Opinion in Pulmonary Medicine 21 (2015): 304-308.
  28. van Vollenhoven P., et al. “Polymerase chain reaction in the diagnosis of urinary tract tuberculosis”. Urology Research 24 (1996): 107-111.
  29. Dochviri TZ., et al. “Detection of mycobacteria tuberculosis in patients with urogenital tuberculosis by PCR method”. Georgian Medical News 119 (2005): 14-17.
  30. Valentini AL., et al. “Diagnostic imaging of genitourinary tuberculosis”. Rays 23 (1998): 126-143.
  31. Traşcă E., et al. “The place and the role of histological examination in diagnostic algorithm of urinary system tuberculosis”. Romanian Journal of Morphology and Embryology 46 (2005): 105-108.
  32. Hemal AK., et al. “Polymerase chain reaction in clinically suspected genitourinary tuberculosis: comparison with intravenous urography, bladder biopsy, and urine acid fast bacilli culture”. Urology 56 (2000): 570-574.
  33. Lenk S. “Genitourinary tuberculosis in Germany: diagnosis and treatment”. Urology 50 (20115): 1619-1627.
  34. Sanchez I., et al. “Urinary Tuberculosis: Serious Complications May Occur when Diagnosis is Delayed”. Acta Médica Portuguesa 28 (2015): 382-385.
  35. Lawn SD., et al. “Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point- 353 of-care test”. Lancet Infectious Disease 13 (2013): 349-361.
  36. Walzi G., et al. “Immunological biomarkers of tuberculosis”. Nature Reviews Immunology 11 (2011): 343-354.
  37. “The use of next-generation sequencing technologies for the detection of mutations associated with drug resistance in Mycobacterium tuberculosis complex: technical guide” (2018).
  38. Bhalla M., et al. “Performance of light-emitting diode fluorescence microscope for diagnosis of tuberculosis. International Journal of Mycobacteriology 2 (2013): 174-178.
  39. Lawn SD and Zumla AI. “Tuberculosis (Seminar)”. Lancet 378 (2011): 57-72.
  40. Davis JL., et al. “Diagnostic accuracy of same-day microscopy versus standard microscopy for pulmonary tuberculosis: a systematic review and meta-analysis”. Lancet Infectious Disease 13 (2014): 147-154.
  41. Zajaczkowski T. “Genitourinary tuberculosis: historical and basic science review: past and present”. Central European Journal of Urology 65 (2012): 182-187.
  42. Shevchenko SY and Kulchavenya EV. “Is there screening for urinary tuberculosis?”. Urologia (2017): 34-37.
  43. Cheng VC., et al. “Molecular diagnostics in tuberculosis”. European Journal of Clinical Microbiology and Infectious Diseases 24 (2005): 711-720.
  44. Berry PRM., et al. “An interferon-inducible neutrophil-driven blood transcriptional signature in human tuberculosis”. Letter to Nature 466 (2010): 973-979.
  45. Mistry R., et al. “Gene expression patterns in whole blood identify subjects at risk for recurrent tuberculosis”. Journal of Infectious Disease 195 (2007): 357-365.
  46. Ahmad S. “Pathogenesis, immunology and diagnosis of latent Mycobacterium tuberculosis infection”. Clinical and Developmental Immunology (2011): 814943- 814960.
  47. Shu CC., et al. “Apoptosis associated biomarkers in tuberculosis: promising for diagnosis an prognosis prediction”. BMC Infectious Disease 13 (2013): 45.
  48. Whitworth SH., et al. “Biomarkers of tuberculosis: a research roadmap”. Biomark Medicine 7 (2013): 349-362.
  49. Kraemer ZC., et al. “Complete genome sequencing of Mycobacterium bovis SP38 and comparative genomics of Mycobacterium bovis and M. tuberculosis strains”. Frontiers in Microbiology 8 (2017): 1-10.
  50. Mortazavi A., et al. “Mapping and quantifying mammalian transcriptomes by RNA-seq”. Nature Methods 5 (2008): 621-628.
  51. Malone JH and Oliver B. “Microarrays, deep sequencing and the true measure of the transcriptome”. BMC Biology 9 (2011): 34-43.
  52. Fabregat A., et al. “Reactome pahway analysis: A high performance in memory approach”. BMC Bioinformatics 18 (2017): 142.
  53. Favela-Hernández JM., et al. “Evaluation of Mycobacterium bovis isolated from cattle in Mexico for serum reactivity and antigen production kinetics”. Journal of Medical Microbiology and Diagnoses 8 (2019): 1-6.
  54. Sánchez-Garza JJ., et al. “Direct DNA modified CTAB preparation from nasal exudate in live M. bovis infected cattle in Mexico provide with a valuable assay extrapolated to humans TB diagnostic test”. Journal of Tropical Diseases and Public Health 7 (2019): 1-7.


Citation: Gloria G Guerrero., et al. “Clinical, and Diagnostic Characteristics of an Unsuspected Course of Urinary Tuberculosis: A Brief Report". Acta Scientific Microbiology 5.2 (2022): 48-55.


Copyright: © 2022 Gloria G Guerrero., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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