Delayed Diagnosis of Genitourinary Tuberculosis Masquerading as Refractory Bacterial Cystitis

We report a case of genitourinary tuberculosis in a 34-year-old HIV-negative Filipino woman with diabetes mellitus. She presented with chronic cystitis with only partial response to antibiotics. Diagnosis was delayed owing to nonspecific symptoms and prior fluoroquinolone use, which may have partially suppressed Mycobacterium tuberculosis. Reactivation of tuberculosis may have been facilitated by worsening diabetes. This case underscores the importance of considering genitourinary tuberculosis in patients with risk factors of tuberculosis, persistent urinary symptoms, and sterile pyuria. It also highlights the need for early diagnosis to prevent renal damage.