Primary tuberculosis of the penis in a renal transplant patient

Extrapulmonary tuberculosis is a complication of pulmonary tuberculosis that is disseminated through hematogenous or lymphatic system and may involve any organs. We present a case of primary tuberculosis of the penis that is a very rare presentation of tuberculosis. The patient was a 43-year-old man who had kidney transplantation. He admitted with painful ulceration on the glans of penis. Physical examination strongly suggested ulcer lesion that resemble to carcinoma or herpetic ulcer. He did not have any evidence of pulmonary tuberculosis. Having received empiric treatment against herpetic, bacterial and fungal infection, his condition did not improve and he was ordered biopsy of the lesion. Histopathologic studies and PCR revealed Mycobacterium tuberculosis, thus, anti-TB drugs were commenced. The ulcer was improved without any recurrence during a two-year follow up. In patients with kidney transplantation especially in countries endemic for Mycobacterium tuberculosis, chronic ulcer not responding to empiric therapy should be evaluated for Mycobacterium tuberculosis infection

Evaluation of primary failure of new measles vaccine and secondary failure of previous measles vaccine after mass vaccination in military cadets in Iran

Measles is an acute highly infectious respiratory viral disease. It remains a leading cause of death among young children especially in developing country. Measles outbreaks occurred in Iran in recent years and soldiers and cadets have been vaccinated against it. This study was designed to evaluate primary and secondary failure of measles vaccine in cadets after mass measles vaccination. For this cross-sectional study, one month after mass vaccination in 2003, all vaccinated cadets were recruited. Eight hundred and sixty five cadets were evaluated in a simple random fashion. From each individual 5ml blood sample was obtained and checked in immunology laboratory of Baqiyatallah hospital. Antibody was checked by enzyme-linked immunosorbent assay [ELISA] for qualitative and quantitative measurement of IgG and IgM in accordance with Behring ELISA kit [Germany] instructions. Cut-off OD upper than 0.2 was considered positive and quantitative titer upper than 345 mIU/ml was considered protective. All cadets were men with a mean age of 19.0 +/- 1.1 years. IgM anti-measles antibody was positive in 0.7%. Primary failure was positive in 1.8% of individuals. Anti measles IgG antibody was positive in 97.8% of cadets. History of childhood vaccination for measles was positive in 67.7% and past history of measles was positive in 23 cases [2.6%]. Our results showed that secondary failure is more than 97%. Therefore, periodic studies should be performed to assess secondary failure rate in order to take preventive measures in time, of course, if its outbreaks are probable to happen