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1.
BMC Infect Dis ; 21(1): 1068, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34654377

RESUMO

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.


Assuntos
Epididimite , Orquite , Tuberculose dos Genitais Masculinos , Adulto , Idoso , Epididimite/tratamento farmacológico , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Orquite/tratamento farmacológico , Estudos Retrospectivos , Tuberculose dos Genitais Masculinos/diagnóstico , Tuberculose dos Genitais Masculinos/tratamento farmacológico , Tuberculose dos Genitais Masculinos/cirurgia
2.
Comput Math Methods Med ; 2021: 9962970, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34194540

RESUMO

Objective: To discuss the clinical application value of contrast-enhanced ultrasound (CEUS) in testicular occupied lesions. Methods: Nine conventional-ultrasound-found testicular occupied lesions which underwent CEUS meantime were analyzed retrospectively. The CEUS perfusion pattern was compared with the surgical pathological result or follow-up findings. Results: Among all the 9 testicular occupied lesions, there were 5 testicular malignant tumors, 1 testicular benign tumor, 1 testicular tuberculosis, and 2 testicular hematomas. CEUS diagnosed 6 testicular malignant tumors, 1 testicular benign tumor, and 2 testicular hematomas, and its diagnostic accuracy was about 88.9%. Conclusion: CEUS has high clinical application value in the differential diagnoses of benign and malignant testicular occupied lesions.


Assuntos
Doenças Testiculares/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Adulto , Biologia Computacional , Meios de Contraste , Diagnóstico Diferencial , Erros de Diagnóstico , Hematoma/diagnóstico por imagem , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/irrigação sanguínea , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Fosfolipídeos , Estudos Retrospectivos , Hexafluoreto de Enxofre , Neoplasias Testiculares/irrigação sanguínea , Tuberculose dos Genitais Masculinos/diagnóstico por imagem , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricos
3.
Urologiia ; (2): 32-39, 2021 05.
Artigo em Russo | MEDLINE | ID: mdl-33960154

RESUMO

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.


Assuntos
Prostatite , Tuberculose dos Genitais Masculinos , Antibacterianos/uso terapêutico , Doença Crônica , Humanos , Masculino , Prostatite/diagnóstico , Prostatite/tratamento farmacológico , Prostatite/epidemiologia , Tuberculose dos Genitais Masculinos/tratamento farmacológico
4.
Abdom Radiol (NY) ; 46(4): 1677-1686, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33044653

RESUMO

Urogenital tuberculosis is the most common form of extrapulmonary tuberculosis. Genital organ involvement occurs as a continuum of urinary tract tuberculosis and often presents a diagnostic challenge due to the non-specific nature of the symptoms. Delay in diagnosis may lead to complications such as infertility and perineoscrotal sinuses. Imaging plays an important role in raising timely suspicion of tuberculosis. In this article, we describe the imaging findings of male genital tuberculosis and the differential diagnosis. High-resolution ultrasonography (HRUS) is the best modality for assessing the epididymis, testis, scrotum and vas deferens, whereas MRI is optimal for evaluating the prostate, seminal vesicles and ejaculatory ducts. Epididymis is the most common site of genital tuberculosis, and presents as a nodular lesion limited to the tail or as diffuse enlargement. The proximal vas deferens is also frequently involved due to anatomical contiguity and shows diffuse or nodular thickening. Advanced cases may show pyocele formation and scrotal wall sinuses. Testicular involvement is almost always secondary to epididymal tuberculosis and presents as single or multiple nodules, diffuse enlargement, or the 'miliary' pattern. Isolated testicular involvement should raise suspicion of malignancy. Tuberculosis of the prostate is often asymptomatic. The most common imaging manifestations are nodules and the diffuse forms, which may later evolve into abscesses. Fibrosis and calcification occur with healing. Seminal vesicle and ejaculatory duct involvement with fibrosis may cause infertility. Awareness of the imaging findings would enable the radiologist to raise timely suspicion, so that prompt treatment is initiated and complications are prevented.


Assuntos
Doenças dos Genitais Masculinos , Tuberculose dos Genitais Masculinos , Tuberculose , Diagnóstico Diferencial , Epididimo , Doenças dos Genitais Masculinos/diagnóstico por imagem , Genitália Masculina , Humanos , Masculino , Tuberculose dos Genitais Masculinos/diagnóstico por imagem
5.
Hinyokika Kiyo ; 66(10): 363-367, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33271651

RESUMO

Beginning in May 2016, an 83-year-old male underwent three transurethral resections for recurrent bladder cancer. In June 2017, following a positive urine cytology exam, a random biopsy of the bladder was performed. The histopathological findings revealed urothelial carcinoma, high grade, pTis. Treatment consisted of bacillus Calmette-Guerin (BCG) instillation. In February 2018, he complained of left scrotal swelling and pain ; and, was diagnosed with left epididymitis. However, based on resistance to the antibiotic agent, epididymal tuberculosis after BCG therapy was suspected and resection of the left testis and epididymis was performed. Histopathological findings revealed epididymal tuberculosis. Three months after the left orchiectomy, the patient complained of right scrotal swelling and pain. Based on antibiotic resistance and the positive findings of a urinary mycobacterium tuberculosis polymerase chain reaction assay, metachronous right epididymal tuberculosis was suspected and the patient underwent resection of the right epididymis. While the histopathological findings did not indicate tuberculosis, the urinary mycobacterium culture was positive. The patient was diagnosed with right epididymal tuberculosis and after surgery was administered an antituberculosis drug.


Assuntos
Tuberculose dos Genitais Masculinos , Tuberculose , Neoplasias da Bexiga Urinária , Administração Intravesical , Idoso de 80 Anos ou mais , Vacina BCG/uso terapêutico , Epididimo , Humanos , Masculino , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária/tratamento farmacológico
7.
Indian J Tuberc ; 67(3): 433-437, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32825889

RESUMO

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.


Assuntos
Dermatoses Faciais/patologia , Dermatoses da Perna/patologia , Lúpus Vulgar/patologia , Doenças do Pênis/patologia , Tuberculose Cutânea/patologia , Tuberculose dos Genitais Masculinos/patologia , Adulto , Antituberculosos/uso terapêutico , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/tratamento farmacológico , Antebraço/patologia , Humanos , Dermatoses da Perna/diagnóstico , Dermatoses da Perna/tratamento farmacológico , Lúpus Vulgar/diagnóstico , Lúpus Vulgar/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico , Doenças do Pênis/tratamento farmacológico , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Tuberculose dos Genitais Masculinos/diagnóstico , Tuberculose dos Genitais Masculinos/tratamento farmacológico
10.
Infez Med ; 28(1): 78-81, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32172264

RESUMO

Testicular tuberculosis (TB) is a rare presentation of extrapulmonary TB. A 46-year-old man presented to our Urology clinic with a painless swelling of the right testis. Examination revealed a hard, non-tender swelling on the inferior pole of the testis that measured 3 x 2 cm. Scrotal ultrasound scan showed a complex mass with multiple hypoechoic lesions at the inferior pole of the right testis with dimension 2.4 x 1.7cm. Laboratory data showed elevated alpha fetoprotein and beta hcG and lymphocytosis. A diagnosis of right testicular cancer was made and the patient had a right transinguinal radical orchidectomy. Histopathology result showed tuberculous granulomata with caseous necrosis surrounded by multinucleated giant cells (Langerhan`s type). The patient subsequently had anti-TB medications. The rarity of this condition makes these findings important to report.


Assuntos
Neoplasias Testiculares/diagnóstico , Tuberculose dos Genitais Masculinos/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Ultrassonografia
11.
S Afr J Surg ; 57(4): 43, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31773934

RESUMO

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.


Assuntos
Antituberculosos/uso terapêutico , Mycobacterium tuberculosis/isolamento & purificação , Prostatite/tratamento farmacológico , Prostatite/microbiologia , Tuberculose dos Genitais Masculinos/patologia , Idoso , Biópsia por Agulha , Diagnóstico Diferencial , Seguimentos , Humanos , Hospedeiro Imunocomprometido , Imuno-Histoquímica , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Imageamento por Ressonância Magnética/métodos , Masculino , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/etiologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/etiologia , Prostatite/patologia , Doenças Raras , Medição de Risco , África do Sul , Resultado do Tratamento , Tuberculose dos Genitais Masculinos/diagnóstico , Tuberculose dos Genitais Masculinos/tratamento farmacológico
13.
Am J Trop Med Hyg ; 101(5): 1070-1072, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31482781

RESUMO

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.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Orquite/microbiologia , Tuberculose dos Genitais Masculinos/microbiologia , Adulto , Antituberculosos/uso terapêutico , Epididimo/microbiologia , Epididimo/patologia , Etiópia/epidemiologia , Humanos , Masculino , Tuberculose dos Genitais Masculinos/tratamento farmacológico , Tuberculose dos Genitais Masculinos/epidemiologia , Tuberculose dos Genitais Masculinos/patologia
14.
Sci Rep ; 9(1): 11053, 2019 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-31363115

RESUMO

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.


Assuntos
Tuberculose dos Genitais Femininos/diagnóstico , Tuberculose dos Genitais Masculinos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibióticos Antituberculose/uso terapêutico , Farmacorresistência Bacteriana , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium tuberculosis , Rifampina/uso terapêutico , Tuberculose dos Genitais Femininos/tratamento farmacológico , Tuberculose dos Genitais Femininos/urina , Tuberculose dos Genitais Masculinos/tratamento farmacológico , Tuberculose dos Genitais Masculinos/urina , Tuberculose Resistente a Múltiplos Medicamentos/urina , Adulto Jovem
16.
Clin Nucl Med ; 44(9): 757-760, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31107741

RESUMO

Isolated genital tuberculosis is rare. We present a case of bilateral tuberculous epididymo-orchitis showing high FDG uptake on FDG PET/CT. In addition, the patient had a prostatic FDG-avid lesion, consistent with tuberculous prostatitis. This case indicates tuberculous epididymo-orchitis, especially in tuberculosis-endemic regions, should be considered as a differential diagnosis in patients with hypermetabolic epididymal or testicular lesions, including benign and malignant tumors, bacterial epididymo-orchitis, abscess, idiopathic granulomatous orchitis, and sarcoidosis.


Assuntos
Epididimite/complicações , Fluordesoxiglucose F18 , Orquite/complicações , Orquite/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tuberculose dos Genitais Masculinos/complicações , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
17.
An Bras Dermatol ; 94(2): 236-238, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31090835

RESUMO

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.


Assuntos
Diagnóstico Tardio , Hanseníase Virchowiana/diagnóstico , Doenças Testiculares/tratamento farmacológico , Tuberculose dos Genitais Masculinos/tratamento farmacológico , Úlcera/diagnóstico , Adulto , Braço , Humanos , Hanseníase Virchowiana/complicações , Masculino , Orquite/complicações , Orquite/diagnóstico , Doenças Testiculares/patologia , Tempo para o Tratamento , Úlcera/complicações
18.
An. bras. dermatol ; 94(2): 236-238, Mar.-Apr. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1001142

RESUMO

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.


Assuntos
Humanos , Masculino , Adulto , Doenças Testiculares/tratamento farmacológico , Tuberculose dos Genitais Masculinos/tratamento farmacológico , Úlcera/diagnóstico , Hanseníase Virchowiana/diagnóstico , Diagnóstico Tardio , Orquite/complicações , Orquite/diagnóstico , Braço , Doenças Testiculares/patologia , Úlcera/complicações , Hanseníase Virchowiana/complicações
19.
Medicine (Baltimore) ; 98(11): e14843, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30882677

RESUMO

To investigate the sonographic findings of the vas deferens in male genital tuberculosis.The ultrasonographic findings of the vas deferens of 19 cases of genital tuberculosis were retrospectively analyzed.According to the pathological and ultrasound findings, the ultrasonographic appearances of the vas deferens tuberculosis could be divided into 4 groups, 1 of normal sonograms, 3 of abnormal sonograms. The abnormal ultrasonographic appearances of the vas deferens tuberculosis were considered 3 categories as follows: diffusely thickening of vas deferens, nodular thickening of vas deferens, and space-occupying lesions adjacent to the vas deferens.The ultrasound manifestations of vas deferens in tuberculosis of the male genital system have certain characteristics. Combination of clinical manifestations, history of tuberculosis, experimental antituberculosis treatment, and ultrasound examination of vas deferens can suggest tuberculosis of vas deferens. Furthermore, it can provide objective basis for the comprehensive and noninvasive evaluation of the impact of genital tuberculosis on the reproductive ability for further treatments.


Assuntos
Tuberculose dos Genitais Masculinos/diagnóstico , Ultrassonografia/métodos , Ducto Deferente/diagnóstico por imagem , Adulto , China , Humanos , Masculino , Estudos Retrospectivos , Tuberculose dos Genitais Masculinos/complicações , Ultrassonografia/estatística & dados numéricos , Ducto Deferente/anormalidades
20.
J Infect Dev Ctries ; 13(3): 261-264, 2019 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-32040458

RESUMO

Extrapulmonary tuberculosis (EPTB) accounted for 14% of 6.4 million cases of TB that were reported to WHO in 2017, and genitourinary TB (GUTB) is the second most common type of EPTB. The most common site of GUTB is the kidneys and testicular TB is relatively rare. The case of one patient with pulmonary and testicular TB caused separately by two different genotypes of Mycobacterium tuberculosis (Mtb) is further rare. Here, we present an unusual case of TB in which pulmonary TB (PTB) and testicular TB were caused by Mtb isolates with two different genotypes in a 91-year-old male patient from Zunyi, Guizhou Province of China. A better understanding of the mechanism by which a small number of tubercle bacilli are spread from the primary site of PTB to more distant parts/organs of the body, and what factors determine the potential EPTB site will provide us with new ways to prevent and control EPTB infections.


Assuntos
Coinfecção/diagnóstico , Genótipo , Mycobacterium tuberculosis/classificação , Mycobacterium tuberculosis/isolamento & purificação , Doenças Testiculares/diagnóstico , Tuberculose dos Genitais Masculinos/diagnóstico , Tuberculose Pulmonar/diagnóstico , Idoso de 80 Anos ou mais , China , Coinfecção/microbiologia , Humanos , Masculino , Mycobacterium tuberculosis/genética , Doenças Testiculares/complicações , Doenças Testiculares/microbiologia , Tuberculose dos Genitais Masculinos/complicações , Tuberculose dos Genitais Masculinos/microbiologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/microbiologia
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