Asunto(s)
Tuberculosis de los Genitales Masculinos , Humanos , Masculino , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/patología , Enfermedades de la Próstata/diagnóstico , Enfermedades de la Próstata/microbiología , Enfermedades de la Próstata/patología , Enfermedades de la Próstata/diagnóstico por imagen , Persona de Mediana Edad , Antituberculosos/administración & dosificaciónAsunto(s)
Neoplasias Testiculares , Humanos , Masculino , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patología , Diagnóstico Diferencial , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Enfermedades Testiculares/diagnóstico , Testículo/diagnóstico por imagen , Testículo/patología , Tuberculosis/diagnóstico , AdultoAsunto(s)
Hidradenitis Supurativa , Linfadenopatía , Tuberculosis Cutánea , Humanos , Hidradenitis Supurativa/diagnóstico , Tuberculosis Cutánea/diagnóstico , Tuberculosis Cutánea/patología , Tuberculosis Cutánea/tratamiento farmacológico , Diagnóstico Diferencial , Masculino , Linfadenopatía/patología , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/patología , AdultoRESUMEN
Epididymal tuberculosis is rare and often presents diagnostic difficulties. It may be indicative of a disseminated form of the infection, which is the case of our patient. A 19-year-old man, with no past medical history, was admitted for a swollen painful left scrotum that had been evolving for 8 months. He had undergone an orchiectomy and the anatomopathological examination was consistent with epididymal tuberculosis. The radiological investigations had revealed other localizations of the infection: lymphatic, pulmonary, parietal and osteoarticular tuberculosis. Anti-tuberculosis therapy was introduced. However, in the 4th month of treatment, the patient developed seizures. A cerebral magnetic resonance imaging was practiced, concluding to cerebral tuberculomas. Anti-tuberculosis treatment was continued associated to an anticonvulsant with a favourable outcome. The originality of our observation resides in the mode of revelation of a disseminated paucisymptomatic tuberculosis, by an epididymal localization, in an immunocompetent patient.
Asunto(s)
Antituberculosos , Epidídimo , Inmunocompetencia , Imagen por Resonancia Magnética , Tuberculosis de los Genitales Masculinos , Humanos , Masculino , Adulto Joven , Antituberculosos/administración & dosificación , Epidídimo/patología , Epidídimo/microbiología , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Orquiectomía , Convulsiones/etiología , Anticonvulsivantes/administración & dosificación , Tuberculoma Intracraneal/diagnóstico , Tuberculoma Intracraneal/tratamiento farmacológicoRESUMEN
RATIONALE: Prostate tuberculosis (PTB) has no specific symptoms, or insidious presentation in male reproductive system tuberculosis, and is difficult to detect in the early stage. When PTB develops to the late stage, it leads to disease progression and irreversible organ and tissue damage. At present, the imaging manifestations of prostate tuberculosis vary and are not well known to imaging physicians and urologists. DIAGNOSES AND INTERVENTIONS: This case was a PTB patient, whose main manifestation was elevated serum prostate-specific antigen and the diagnosis was confirmed by ultrasound-guided prostate biopsy. We analyzed the imaging performance of various imaging techniques, and summarized and explored the imaging characteristics reported in the previous literature, with the aim of improving the early detection rate and providing evidence-based practice for early regular antituberculosis treatment in PTB. OUTCOMES: The multiparametric transrectal ultrasound performance of PTB is characteristic, and can be used for the differential diagnosis of prostate cancer causing elevated prostate-specific antigen levels in aged men.
Asunto(s)
Neoplasias de la Próstata , Prostatitis , Tuberculosis de los Genitales Masculinos , Humanos , Masculino , Anciano , Próstata/diagnóstico por imagen , Próstata/patología , Antígeno Prostático Específico , Imagen por Resonancia Magnética/métodos , Biopsia Guiada por Imagen/métodos , Neoplasias de la Próstata/patología , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológicoRESUMEN
OBJECTIVES: To determine the earliest noticeable manifestation and diagnosis in patients diagnosed with tuberculosis (TB) epididymitis/epididymo-orchitis incidentally and to analyze their responses to surgical and medical treatment. METHODS: Patients who underwent surgery for the preliminary impression of chronic epididymitis/epididymo-orchitis or epididymal/testicular tumor from 2000 to 2019 were included in the study. The clinical presentations, laboratory data, radiological examinations, and operative findings were analyzed retrospectively. The outcomes were assessed by the responses to anti-TB chemotherapy and post treatment radiographic evaluations. RESULTS: All of our 25 patients with a mean age of 60.6 years were diagnosed incidentally with TB epididymitis (48.0%) and TB epididymo-orchitis (52.0%) according to the histopathological findings from their surgeries. The presence of a palpable scrotal mass (76.0%), was the major presentation. Nineteen (76.0%) patients had undergone complete chemotherapy after the surgery and 15 (78.9%) patients showed complete recovery. Four (21.1%) patients had unfavorable outcomes, 3 had TB autonephrectomies and 1 required re-surgery years after complete chemotherapy. Of the 3 (12.0%) patients who did not receive chemotherapy after their surgeries, 1 had a TB relapse in the spine and lung and 1 developed bladder cancer years later. CONCLUSION: Tuberculosis epididymitis/epididymo-orchitis is difficult to diagnose. However, some clinical clues can assist including aged patients, extragenital TB histories, poor responses to antibiotic treatment and scrotal skin lesion. Complete anti-TB chemotherapy is mandatory even after the total removal of TB lesion. Supplemental surgical interventions can be considered when the symptoms are not relieved after chemotherapy. Lifespan follow-up is recommended due to high relapse rate.
Asunto(s)
Epididimitis , Orquitis , Tuberculosis de los Genitales Masculinos , Humanos , Masculino , Anciano , Persona de Mediana Edad , Epididimitis/complicaciones , Epididimitis/diagnóstico , Epididimitis/terapia , Orquitis/diagnóstico , Orquitis/terapia , Estudios Retrospectivos , Taiwán/epidemiología , Recurrencia Local de Neoplasia , Tuberculosis de los Genitales Masculinos/terapia , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Antibacterianos/uso terapéuticoRESUMEN
BACKGROUND: Nowadays, most studies of tuberculous epididymo-orchitis (TBEO) are case reports or small sample cohort series. Our study is aimed to present the largest series of TBEO with our management experiences and long-term follow-up outcomes. METHODS: Patients diagnosed with TBEO after surgical procedures at Department of Urology, West China Hospital from 2008 to 2019 were included. All clinical features, auxiliary examination results, treatment and histopathological findings were extracted if available. RESULTS: Eighty-one patients (mean age 50.77 ± 16.1 years) were included. Scrotal swelling (N = 47, 58.0%) and pain (N = 29, 35.8%) were the most common presenting complaint. Pyuria and microscopic hematuria were observed in twenty-two (27.2%) and eight patients (9.9%), respectively. Urine acid fast bacilli cultures were available in 16 patients and all were negative. The mean duration between the onset of symptoms and the definite diagnosis was 6.42 ± 7.0 months. TBEO was considered in 30 (37.0%), tumors in 28 (34.6%) and nonspecific bacterial epididymo-orchitis in 23 (28.4%) patients. All patients received triple therapy of chemotherapy-surgery-pharmacotherapy and definite diagnosis was confirmed through histopathology of surgical specimens. Fifty-five patients were followed up regularly (mean follow-up 82.35 ± 36.6 months). One patient (1.2%) died from liver cirrhosis and no recurrence was observed. Postoperative complications included erectile dysfunction in 4 patients (4.9%), premature ejaculation in 5 patients (6.2%) and sterility in 7 patients (8.6%). CONCLUSIONS: We recommend patients with advanced TBEO to receive triple therapy of chemotherapy-surgery-pharmacotherapy. Physicians should pay more attention to patients' sexual function and fertility during follow up after treatment completed.
Asunto(s)
Epididimitis , Orquitis , Tuberculosis de los Genitales Masculinos , Adulto , Anciano , Epididimitis/tratamiento farmacológico , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Orquitis/tratamiento farmacológico , Estudios Retrospectivos , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/cirugíaRESUMEN
INTRODUCTION: The problem of chronic prostatitis is still to be resolved. AIM: to compare the frequency of the main symptoms (pain, dysuria, sexual dysfunction) in patients with chronic bacterial and abacterial prostatitis, as well as prostate tuberculosis (PTB); to determine the prevalence of latent infectious prostatitis in patients with chronic abacterial prostatitis (CAP). MATERIALS AND METHODS: A total 73 men who were followed with a diagnosis of chronic prostatitis for at least two years and had a history of at least three exacerbations per year were included in the study. A microbiological study of expressed prostate secretions (EPS) was carried out using both routine and molecular genetic methods. RESULTS: Chronic bacterial prostatitis (CBP) was diagnosed in 27 patients (37.0%). 36.7% of pathogens were resistant to antibiotics. In 46 patients (63%) no microflora was not isolated at the first examination. In some patients with CBP, prostate tuberculosis (PTB) was diagnosed. Thus, in the total cohort of patients, only 17 (23.3%) had isolated CBP, and other 10 (13.7%) had CBP in combination with PTB. All patients with CAP received longidaza rectal suppositories for diagnostic purposes. In 23 men (50.0% of patients with CAP), uropathogens were isolated from EPS after administration of longidaza, and 56.9% of them were resistant to antibacterial drugs. Five patients from this group also had PTB, and 18 (24.6%) had CBP, which was not diagnosed by standard methods. There were no significant differences in the frequency of pain and urinary disorders. However, sexual dysfunction more often developed in patients with CAP and PTB (p<0.05); hemospermia, on the other hand, was not typical for patients with CAP, occurred in few cases with CBP and latent CAP, but was present in two-thirds of patients with PTB. CONCLUSION: As a mask of CAP, both latent CPB and PTB can present. Although CBP, CAP, latent CBP and PTB have a number of significant differences in the clinical manifestations, no pathognomonic symptoms have been identified for these subgroups of chronic prostatitis. Considering that half of patients with CAP actually have latent CBP, it is necessary to use rectal suppositories of the drug longidaza for diagnostic purposes with repeated analysis of expressed prostate secretions. To identify pathogens, molecular genetic diagnostics should be used along with routine methods. PTB can manifest as chronic bacterial or abacterial prostatitis. It is necessary to carefully study the patient's history, epidemic history, and, if indicated, to perform an appropriate examination to exclude PTB.
Asunto(s)
Prostatitis , Tuberculosis de los Genitales Masculinos , Antibacterianos/uso terapéutico , Enfermedad Crónica , Humanos , Masculino , Prostatitis/diagnóstico , Prostatitis/tratamiento farmacológico , Prostatitis/epidemiología , Tuberculosis de los Genitales Masculinos/tratamiento farmacológicoAsunto(s)
Epididimitis/diagnóstico por imagen , Orquitis/diagnóstico por imagen , Tuberculosis de los Genitales Masculinos/diagnóstico por imagen , Tuberculosis de los Genitales Masculinos/microbiología , Ultrasonografía/métodos , Adulto , Antituberculosos/uso terapéutico , Biopsia con Aguja Fina/métodos , Diagnóstico Diferencial , Epididimitis/microbiología , Epididimitis/patología , Humanos , Masculino , Orquitis/microbiología , Orquitis/patología , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/patologíaRESUMEN
Cutaneous tuberculosis occurs in 1-2% of world cases of tuberculosis and more common in tropical countries. It presents with different clinical forms. Unusual clinical presentations are not uncommon and awareness of these will help in suspecting and managing these patients successfully. Lupus pernio like lupus vulgaris, tuberculosis of glans penis and lichen scrofulosorum on the distal parts of limbs are presented here because of their unusual clinical presentation.
Asunto(s)
Dermatosis Facial/patología , Dermatosis de la Pierna/patología , Lupus Vulgar/patología , Enfermedades del Pene/patología , Tuberculosis Cutánea/patología , Tuberculosis de los Genitales Masculinos/patología , Adulto , Antituberculosos/uso terapéutico , Dermatosis Facial/diagnóstico , Dermatosis Facial/tratamiento farmacológico , Antebrazo/patología , Humanos , Dermatosis de la Pierna/diagnóstico , Dermatosis de la Pierna/tratamiento farmacológico , Lupus Vulgar/diagnóstico , Lupus Vulgar/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/tratamiento farmacológico , Tuberculosis Cutánea/diagnóstico , Tuberculosis Cutánea/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológicoAsunto(s)
Antituberculosos/uso terapéutico , Etambutol/uso terapéutico , Isoniazida/uso terapéutico , Enfermedades del Pene , Pirazinamida/uso terapéutico , Rifampin/uso terapéutico , Tuberculosis de los Genitales Masculinos , Adulto , Humanos , Masculino , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológicoAsunto(s)
Insuficiencia Suprarrenal/tratamiento farmacológico , Insuficiencia Suprarrenal/microbiología , Antituberculosos/uso terapéutico , Orquitis/microbiología , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Insuficiencia Suprarrenal/diagnóstico , Anciano , Humanos , Masculino , Tuberculosis de los Genitales Masculinos/complicacionesRESUMEN
SUMMARY: Tuberculous (TB) prostatitis is rare; usually occurring in immunocompromised men. It can mimic benign prostatic hyperplasia (BPH), chronic prostatitis or prostate cancer. This report in an immunocompetent 72-year-old man adds to the clinical spectrum of the five prior reported cases. A low threshold for prostatic biopsy led to a histological evaluation and subsequent microbiological confirmation of TB. This attests to the value of such an approach in arriving at the correct diagnosis and the institution of appropriate anti-tuberculous therapy even amongst immune-competent men.
Asunto(s)
Antituberculosos/uso terapéutico , Mycobacterium tuberculosis/aislamiento & purificación , Prostatitis/tratamiento farmacológico , Prostatitis/microbiología , Tuberculosis de los Genitales Masculinos/patología , Anciano , Biopsia con Aguja , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Huésped Inmunocomprometido , Inmunohistoquímica , Síntomas del Sistema Urinario Inferior/diagnóstico , Síntomas del Sistema Urinario Inferior/etiología , Imagen por Resonancia Magnética/métodos , Masculino , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/etiología , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/etiología , Prostatitis/patología , Enfermedades Raras , Medición de Riesgo , Sudáfrica , Resultado del Tratamiento , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológicoRESUMEN
Genitourinary tuberculosis (TB) is a rare but well-described form of extrapulmonary TB. We present a case of a 35-year-old man from Ethiopia with scrotal swelling and fever who was found to have epididymo-orchitis due to Mycobacterium tuberculosis. The patient presented to the hospital multiple times before undergoing operative debridement with fine needle aspiration and tissue biopsy to confirm the diagnosis. He improved with antituberculous therapy. Patients with TB risk factors presenting with epididymitis that is refractory to empiric antibiotic therapy warrant consideration of TB epididymitis. Our case demonstrates the high index of suspicion required to establish a diagnosis of genitourinary TB.
Asunto(s)
Mycobacterium tuberculosis/aislamiento & purificación , Orquitis/microbiología , Tuberculosis de los Genitales Masculinos/microbiología , Adulto , Antituberculosos/uso terapéutico , Epidídimo/microbiología , Epidídimo/patología , Etiopía/epidemiología , Humanos , Masculino , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/epidemiología , Tuberculosis de los Genitales Masculinos/patologíaRESUMEN
Genitourinary tuberculosis (GUTB) accounts for up to 40% of extrapulmonary tuberculosis cases. Rapid tests for GUTB are urgently needed because it is often associated with delayed health-care seeking, leading to serious consequences. This study evaluated the performance of the Xpert MTB/RIF assay in the rapid diagnosis of urinary tract tuberculosis (UTB) and rifampicin-resistant tuberculosis with urine specimens. In all, 302 patients were included from four hospitals in China. Suspected UTB patients were tested with Xpert, smear, and MGIT 960 culture. Drug susceptibility testing (DST) was conducted for culture-positive cases. The performance of the assays was evaluated against MGIT 960 culture and a composite reference standard (CRS). Among all participants, 150 (49.7%) had CRS-positive UTB, of whom 36 (24.0%) were culture-confirmed. Against culture, Xpert and smear achieved a sensitivity of 94.4% (95% CI: 81.3-99.3%) and 22.2% (95% CI: 10.1-39.2%), respectively. Against CRS, the sensitivity of Xpert, smear and culture was 41.3% (95% CI: 33.4-49.7%), 7.3% (95% CI: 3.7-12.7%), and 24.0% (95% CI: 17.4-31.6%). Xpert had better performance than smear and culture in detecting UTB from urine samples and could be considered for the diagnosis of UTB. Moreover, Xpert showed better performance than MGIT 960-based DST using urine culture.
Asunto(s)
Tuberculosis de los Genitales Femeninos/diagnóstico , Tuberculosis de los Genitales Masculinos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Antibióticos Antituberculosos/uso terapéutico , Farmacorresistencia Bacteriana , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Mycobacterium tuberculosis , Rifampin/uso terapéutico , Tuberculosis de los Genitales Femeninos/tratamiento farmacológico , Tuberculosis de los Genitales Femeninos/orina , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/orina , Tuberculosis Resistente a Múltiples Medicamentos/orina , Adulto JovenRESUMEN
Leprosy is a chronic neglected and stigmatizing disease. Due to involvement of the peripheral nerves, it can result in physical disabilities, deformities, and emotional damage if not diagnosed and treated promptly. This is the case of a young patient with testicular pain and swelling and no improvement after a specific therapeutic scheme for tuberculosis. Clinical and laboratory reevaluation revealed hypoesthetic skin patches associated with post-burn crusted ulcers on the left arm, thickening of ulnar nerves, atrophy of interosseous muscles of the hands, positive skin smear microscopy, and testicular histopathology with numerous bacilli forming globi. These findings indicated lepromatous leprosy with type II reaction.
Asunto(s)
Diagnóstico Tardío , Lepra Lepromatosa/diagnóstico , Enfermedades Testiculares/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Úlcera/diagnóstico , Adulto , Brazo , Humanos , Lepra Lepromatosa/complicaciones , Masculino , Orquitis/complicaciones , Orquitis/diagnóstico , Enfermedades Testiculares/patología , Tiempo de Tratamiento , Úlcera/complicacionesRESUMEN
Abstract Leprosy is a chronic neglected and stigmatizing disease. Due to involvement of the peripheral nerves, it can result in physical disabilities, deformities, and emotional damage if not diagnosed and treated promptly. This is the case of a young patient with testicular pain and swelling and no improvement after a specific therapeutic scheme for tuberculosis. Clinical and laboratory reevaluation revealed hypoesthetic skin patches associated with post-burn crusted ulcers on the left arm, thickening of ulnar nerves, atrophy of interosseous muscles of the hands, positive skin smear microscopy, and testicular histopathology with numerous bacilli forming globi. These findings indicated lepromatous leprosy with type II reaction.
Asunto(s)
Humanos , Masculino , Adulto , Enfermedades Testiculares/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Úlcera/diagnóstico , Lepra Lepromatosa/diagnóstico , Diagnóstico Tardío , Orquitis/complicaciones , Orquitis/diagnóstico , Brazo , Enfermedades Testiculares/patología , Úlcera/complicaciones , Lepra Lepromatosa/complicacionesRESUMEN
Tuberculosis (TB) is a global disease and if not adequately treated can lead to morbidity and mortality. Though genitourinary TB is common and only next to pulmonary TB, cutaneous 'ulcerative' tuberculosis of the scrotum is not reported so far in the literature. We present a 32-year-old man with a non-healing scrotal ulcer and underwent excision. Histopathology was consistent with TB. Antitubercular therapy was given and at the end of a year's follow-up, there has been no recurrence. TB of the scrotum should be considered in the differential diagnosis of scrotal ulcers. Proper diagnosis and adequate treatment will offer a cure to such patients.
Asunto(s)
Escroto , Tuberculosis de los Genitales Masculinos/diagnóstico , Adulto , Antituberculosos/uso terapéutico , Humanos , Masculino , Úlcera Cutánea/etiología , Úlcera Cutánea/patología , Úlcera Cutánea/cirugía , Tuberculosis de los Genitales Masculinos/complicaciones , Tuberculosis de los Genitales Masculinos/tratamiento farmacológico , Tuberculosis de los Genitales Masculinos/cirugíaRESUMEN
In India urogenital tuberculosis is the second commonest form of extra-pulmonary tuberculosis. Kidney is the highest and prostate is the least affected urogenital organ. But the extreme stage of renal tuberculosis named as 'putty' kidney is a rare manifestation. In general most cases of urogenital tuberculosis are quasi-symptomatic, and therefore an uttermost apprehension is needed from physicians to intercept such cases at the earliest. In this presentation we describe a case of 'putty' kidney, and another incidental association of prostate tuberculosis with benign prostatic hyperplasia.