Infection (Bacterial, Fungal or Viral)

Many patients are stunned to find themselves tested for almost every sexually disease known to man, even if they are virgins or haven’t been intimate in years. This is a normal and proper diagnostic evaluation. Many other patients assume that their symptoms are triggered by bacterial infection and self medicate with antibiotics despite the lack of any testing proving that they have infection. You deserve more than a guess. It’s important to have essential testing to determine if you have infection, including not only bacteria but fungal and viral infections.

There are some key pathogenic infections that should be ruled out, including:

Mycobacterium tuberculosis

While normally found in the lungs, tuberculosis can spread throughout the body, including to the kidneys, the bladder, the prostate, the epididymis and the urethra. Because patients often focus on other, more common infections, a diagnosis of TB could be missed.

Chlamydia

One of the most common sexually transmitted diseases, chlamydia can infect the urinary tract in both men and women.

Ureaplasma & Mycoplasma

Remarkably tiny bacteria that cannot be seen through a microscope, ureaplasma and mycoplasma are normal to the human biome where they help you digest food, fight infections and maintain your normal reproductive tract health. They can, however, become overgrown and lead to a pathogenic infection. Ureaplasma is most known for causing infection of the urethra where it will trigger pain during urination (urethritis), burning and a discharge. Ureaplasma is also associated with bacterial vaginosis where it can cause a watery discharge and unpleasant order. Mycoplasma is associated with urethritis, cervicitis, infertility and pelvic inflammatory disease. These are extremely difficult to culture thus the best way to identify these infections is with Next Generation DNA Urine testing (www.bladderhealth.org).

Corynebacterium

If you’ve heard of the devastating outbreaks of diptheria in years past, those were caused by a type of bacteria known as corynebacterium. Thankfully, they are now preventable with vaccinations. But, non diptheroid corynebacterium infections can also occur, particularly in patients who are immune compromised. They are frequently associated with intravascular catheters and artificial heart valves.

Candida

It’s important for patients to understand that urinary tract infections are not always the result of bacteria. The bladder can also become infected with an overgrowth of fungi (i.e candida), especially in patients who have used a lot of antibiotics. If a patient is strug gling with chronic yeast infections in the vagina, there is a strong likelihood that the candida could also be infecting the bladder. The MAPP Research Network recently discovered that many patients struggling with IC flares had candida in their urine. Unfortunately, typical urine cultures do not identify fungus but Next Generation DNA Urine testing does. Candida infections in the urinary tract can trigger all of the symptoms we associate with IC: frequency, urgency, pressure and intense pain. They are treated with anti fungal medications though treatment is becoming more challenging with an increase in drug resistance.

Herpes

Patients who struggle with herpes may notice that their IC symptoms intensify during herpes flares. Genital herpes can cause blisters anywhere in the crotch area, including vulva, rectum and urethra. Herpes infections of the bladder wall have been documented but are considered rare. They are treated with antiviral medications such as Valtrex, Famvir or Zovirax. Treatment should begin as soon as symptoms are noticed.

Human papilloma virus

HPV is now the most common sexually transmitted infection. Known for affecting skin and membranes of the body, HPV 6 and 7 cause more than 90% of the genital warts. Tragically, other HPV types are known to trigger a variety of cancers, including rectal, urethral, vulvar, mouth, throat and others. Vaccination can prevent HPV infection.

Chronic, fastidious infection

Chronic, fastidious infection has been suggested by a few medical care providers and patients for years, suggesting that IC patients could have an infection that is not identifiable via typical urine tests. Dr. James Malone-Lee (UK) believes that all urine testing is flawed because it cannot prove that any identified bacteria is the root cause of their symptoms. He advocates for the testing of urine via microscopy in search of the presence of white blood cells which he assumes is the result of bacterial infection. His suggestion of long- term antibiotic use has gained little traction among national urology associations and experts who are advocating for antibiotic stewardship. One critical flaw in this theory is that white blood cells may also be present due to fungal or viral infection, inflammation and, of course, injury. That said, there is a small but vocal group of patients who believe that long-term antibiotic therapy has cured them.