Incidentally detected tuberculous prostatitis with microabscess

ABSTRACT Tuberculous prostatitis is a rare and often overlooked entity that may mimic prostatic adenocarcinoma on imaging exams, especially multiparametric magnetic resonance imaging (MRI) of the prostate. Detection of a prostatic abscess is a clue to the correct diagnosis.

Tuberculosis genitourinaria en paciente con sida / Genitourinary tuberculosis in an AIDS patient

Introducción: la tuberculosis es una enfermedad con una alta prevalencia en los países en vías de desarrollo. Entre los casos de tuberculosis extrapulmonar, la tuberculosis genitourinaria es común y esta situación se acentúa en los pacientes con sida. Objetivo: describir las características clínicas de un paciente que presentó tuberculosis genitourinaria detectada mediante el empleo de la reacción en cadena de la polimerasa. Presentación del caso: paciente masculino de 34 años de edad, seropositivo al virus de la inmunodeficiencia humana desde 2004, con antecedentes de tuberculosis pulmonar, que ingresa en junio de 2014 en el Hospital del Instituto de Medicina Tropical Pedro Kourí refiriendo fiebre de alrededor de dos meses de duración, intermitente, vespertina, acompañada de sudoraciones profusas y pérdida de peso importante. Además, se constata la presencia de disuria desde el comienzo de la fiebre. Recibió varios tratamientos con antibióticos sin respuesta. Se detecta Mycobacterium tuberculosis en la orina del paciente mediante la reacción en cadena de la polimerasa. Tres meses después, es reevaluado y se encuentra afebril, con aumento de peso, evolución clínica favorable y continúa con la primera fase de tratamiento anti-tuberculosis. Conclusiones: el evento ocurrido en este caso sugiere que los facultativos deben pensar en el diagnóstico de la tuberculosis genitourinaria en los pacientes con sida(AU)

Introduction: tuberculosis is highly prevalent in developing countries. Genitourinary tuberculosis is a common type of extrapulmonary tuberculosis, particularly in AIDS patients. Objective: describe the clinical characteristics of a patient with genitourinary tuberculosis detected by polymerase chain reaction. Case presentation: amale 34 year-old patient seropositive for human immunodeficiency virus since the year 2004 and a history of pulmonary tuberculosis is admitted in 2014 to the hospital at Pedro Kouri Tropical Medicine Institute. The patient had had intermittent vespertine fever for about two months as well as profuse sweating and considerable weight loss. Dysuria had also been present since the onset of fever. The patient had received several antibiotic treatments with no response. Mycobacterium tuberculosis was detected in the patient's urine by polymerase chain reaction. Re-evaluation performed three months later found that the patient was afebrile, had gained weight and his clinical evolution was favorable. The patient continues at the first stage of tuberculosis treatment. Conclusions: the event described suggests that physicians should consider genitourinary tuberculosis in their evaluation of AIDS patients(AU)

Polaciúria incapacitante para a vida usual. Relato de tuberculose da bexiga. A tuberculose permanece no rol do diagnóstico diferencial da maioria das doenças / Incapacitating pollakiuria affecting daily life. A case report of tuberculosis of the bladder. Tuberculosis remains on the list of the differential diagnoses for most diseases

A tuberculose (TB) é dos mais graves problemas de saúde humano e associa-se a pobreza, incipiência do sistema de saúde, deficiência de gestão que dificulta a diminuição de doenças de determinismo social, epidemia do vírus da imunodeficiência humana e imunodeficiência adquirida e multirresistência do M. tuberculosis. O acometimento extrapulmonar ocorre em 15% dos casos de TB e pode evoluir com amesma sintomatologia geral do acometimento pulmonar, com variações na dependência de sua localização e gravidade. Este relato apresenta paciente com hematúria e polaciúria incapacitante para a vida social, associada inicialmente à neoplasia, e determinada pela TB geniturinária, com diagnóstico após histopatologia de espécime clínico obtido da bexiga, em que o tempo longo para o diagnóstico foi determinante para grave sequela. Objetiva alertar para a TB como doença permanente no Brasil ea necessidade de ser considerada sempre como diagnóstico diferencial de doenças pulmonares ou extrapulmonares.

Tuberculosis (TB) is among the most serious human health concerns and is associated with poverty, limited availability of health care services and bad management, all of which negatively affect the possibility of reducing socially-determined diseases, such as HIV/AIDS epidemics and multidrug resistant M. tuberculosis. Extrapulmonary involvement occurs in 15% of TB cases and can develop with the same overall symptomatology of exclusively pulmonary involvement, with smaller variations depending on location and severity. This report presents a patient with hematuria and pollakiuria with incapacitating effects on social life, initially thought of as a malignancy and later identified as genitourinary TB. Diagnosis was based on histopathology of clinical specimens from the bladder. Time elapsed between onset and diagnosis led to considerable sequelae. This report aims at raising awareness of TB as a permanent concern in Brazil and of the need to always considered it as a differential diagnosis of pulmonary or extrapulmonary disease.

Orquitis tuberculosa aislada / Isolated tuberculous orchitis

Presentación de un caso poco frecuente de tuberculosis genital aislada, en un hombre de 28 años, no fumador, sin antecedentes clínicos significativos...

Prostatic tuberculosis: case report / Tuberculosis prostática: informe del caso

CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

CONTEXTO: La tuberculosis prostática ha sido principalmente descrita en pacientes inmunodeprimidos. Sin embargo, es excepcional como lesión aislada en pacientes inmunocompetentes. CASO CLINICO: Describimos el caso de un varón sano e inmunocompetente con tuberculosis prostática y hallazgos irrelevantes en la urografía de eliminación realizada. La tomografía computerizada (TC) mostró un absceso en próstata, aislándose en el urocultivo Mycobacterium tuberculosis. El tratamiento con isoniazida, rifampicina y pirazinamida fue exitoso.

Pituitary tuberculosis.

Tuberculous involvement of pituitary is extremely rare and is usually not suspected while dealing with pituitary adenomas, even in patients with history of systemic tuberculosis. We report a case of pituitary tuberculoma in a patient who was undergoing treatment for prostatic tuberculosis. Although diagnosis of sellar tuberculomas is difficult on clinical and radiological examinations, pituitary tuberculomas should be considered in the differential diagnosis of suprasellar masses, especially in developing countries as the condition is potentially curable with antituberculous treatment.

Probable tuberculosis en lesión ulcerada en pene / probable tuberculosis in ulcer in penis

Presentamos el caso de un varón de 52 años de edad que presentaba una lesión ulcerativa en el glande, de 20 años de evolución, habiendo recibido diferentes tipos de tratamiento sin éxito. La lesión presentaba bordes irregulares, consistencia dura y no había dolor. El estudio histopatológico mostró granuloma necrótico, BAAR positivo, sugestivo de TBC.

Spermatic granuloma presenting as an epididymal nodule: fine needle aspiration cytological findings and differential diagnosis.

Spermatic granuloma is a granulomatous lesion that presents clinically as a nodular lesion in the region of epididymis. There are only few documented cases of spermatic granuloma in the literature. Fine needle aspiration (FNA) reveals mixed inflammatory cells comprising of plenty of macrophages along with lymphocytes and scattered polymorphs in a fluidy background containing many spermatozoa and sperm heads. Sperm heads are also noted within macrophages. Ill formed to well-formed granulomas were seen in all the cases. FNA has an important role in the differential diagnosis of epididymal nodule as it can rule out malignancy and other benign cytological diagnosis like tuberculosis, acute and chronic epididymo-orchitis. Distinction of spermatic granulomas from the more common tuberculous granulomatous infection is important from the cytopathologist's point of view. By providing an accurate and rapid diagnosis, FNA prevents aggressive and potentially inappropriate surgical procedures.

Testicular tuberculosis mimicking testicular malignancy.

A 22 years old male presented with right sided scrotal swelling of 5 months duration. On examination it was found to be of orange-sized, firm to hard in consistency with mild tenderness. Ultrasonography of testes failed to arrive at a diagnosis. However, fine needle aspiration cytology of the testicular swelling confirmed the diagnosis of testicular tuberculosis. Even conservative approach in the management gave satisfactory result.

Tuberculoma of the spermatic cord

Objective and importance: Tuberculoma of the intrascrotal cord is rare. There were only 8 other cases reported in the English literature. Clinical presentation: A 40-year-old man presented with a painless mass in the left scrotal region. Preoperated frozen section showed it to be a tuberculous lesion. Intervention or technique: The mass was excised in toto and the final histopathology confirmed the frozen section and antituberculous drugs were administered. An awareness of this condition would prevent an orchidectomy on the patient for a benign lesion

Tuberculosis vegetante / Vegetans tuberculosis

Imformamos un caso de tuberculosis vegetante perianal. Un hombre de 59 años presentaba múltiples vegetaciones fistulizadas alrededor del ano y genitales. El disgnóstico fue confirmado por cultivo. La cirugía y agentes tuberculostáticos fueron efectivos. Presentamos una revisión bibliográfica reciente

TB epididymitis is not uncommon incident

100 cases of epididymitis were randomly chosen provided that they didn't receive antibiotics in the last 48 hours. We categorized the patients into two groups: those presenting with acute painfull scrotal swelling and fever into group A [5 6 patient] and those presenting with painless scrotal lumb of more than 3 months duration into group B [44 patients]. - Full clinical assessment including careful history taking and clinical examination was done to all patients. - Urine smears stained with Z.N. -staining were examined for alcohol and acid fast bacilli for all patients, and similar semen smears for group [B] patients were also done. - Urine culturing on Lowenstein-Jensen medium was done for all patients. - Semenogram was done for group [B] patients. - Semen of group [B] patients was cultured also on Lewenstein-Jensen medium. Abdominal ultrasound together with chest x-ray and plain x-ray abdomen had been performed to all cases. In Group [B] patients, I V.U was routinely done. It is clear that chronic epedidymitis is highly suspecious for T.B. It had been found that semen culturing or smearing by Z-N-Stain gave a better chance-than urine to isolate the T-B bacillus [semen smearing and culturing proved that 15.9% and 29% of patients respectively were positive for T.B. bacilli compared to 13.6% and 25% of patients in case of urine]. Semen parameters had been variably affected in tuberculous involvement of the epididymitis specially in bilateral cases [all bilateral cases and 3 out of 8 unilateral involvement were infertile]. In conclusion, T.B. bacillus is a relatively common causative organism in cases of chronic epididymitis [13% of total cases of epididymitis and 29% of chronic cases]

Tuberculose isolada do epidídimo / Isalated tuberculosis of the epididymis

É apresentado um caso de tuberculose epididimária isolada num paciente de 38 anos, masculino, branco. Enfatiza-se a raridade do achado, bem como o fato da evoluçäo do quadro ter sido após a ocorrência de traumatismo escrotal

The role of transrectal fine needle aspiration cytology in the diagnosis of prostatic nodules suspicious of malignancy--a study of 126 cases.

Transrectal fine needle aspiration cytology by Franzen technique was carried out in 126 patients having enlarged prostate which were suspicious of malignancy by clinical per rectal examination. Analysis showed benign adenoleiomyomatous hyperplasia in 40 cases, chronic prostatitis in 4 cases, tuberculosis of prostate in 4 cases, malignancy in 76 cases and 2 cases were reported as suspicious of malignancy. Comparison of aspiration cytology with histopathology, serial serum acid phosphatase estimation, repeat a spiration cytology after hormone therapy with or without orchiectomy and clinical follow up showed accuracy of cytologic diagnosis of 98.4 per cent. False negative was 1.6 per cent. There was no false positive diagnosis. No complication was encountered in this procedure.