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1.
Br J Radiol ; 95(1129): 20210713, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34586884

RESUMO

OBJECTIVES: This study aimed to investigate the contrast-enhanced ultrasound (CEUS) appearances of prostate tuberculosis (PTB) and its correlation with histopathology. METHODS: Clinical, transrectal ultrasonography (TRUS) and CEUS data of 12 PTB patients confirmed by pathology were retrospectively analyzed, and compared to the pathological findings to identify the pathological structures corresponding to different image enhancement areas. RESULTS: No specific characteristics could be found for the clinical appearances. Enlarged gland, hypoechoic lesions and calcification due to PTB could be found by TRUS, which were also non-specific. CEUS showed hypo- or non-enhanced lesions with varying size, which were related to different pathological stages of PTB. The incidence rate of non-enhanced lesions was 83.3%. The detection rate of suspected lesion by CEUS was significantly higher than that by TRUS (χ2 = 8.000, p = 0.005). Histopathology showed that the hypoenhanced area consisted of tuberculous granulomas, caseous necrosis and incomplete destruction of the glands, while the non-enhanced area consisted of caseous or liquified necrosis. CONCLUSION: CEUS could improve the detection rate of PTB lesions, and the diversity of its manifestations was related to different pathological structures. An enlarged, soft gland with non-enhanced on CEUS may provide valuable information for the diagnosis of PTB, but it is not a substitute for biopsy due to the diversity of CEUS findings. ADVANCES IN KNOWLEDGE: When the lesions of prostate gland are unclear in TRUS examination, CEUS is an ideal option for the detection of lesions, which is conducive to targeted guidance of biopsy areas.


Assuntos
Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/patologia , Tuberculose Urogenital/diagnóstico por imagem , Tuberculose Urogenital/patologia , Ultrassonografia de Intervenção/métodos , Adolescente , Adulto , Meios de Contraste , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
2.
Trop Med Int Health ; 26(7): 753-759, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33817915

RESUMO

OBJECTIVES: To describe characteristics, details of diagnosis and outcomes of urogenital tuberculosis (UGTB) in a low-prevalence country. METHODS: We conducted a retrospective observational study of 37 consecutive patients diagnosed with UGTB between 1st January 2014 and 31st October 2019 in an East London hospital. RESULTS: 68% (25/37) of patients were male and the median age was 42 years (IQR 34-55). 89% (33/37) of patients were born outside the United Kingdom with 65% (24/37) born in the South Asian region. Renal (32.4%), epididymal (24.3%) and endometrial TB (21.6%) were the most prevalent forms of UGTB. Only 13.5% of UGTB patients had concurrent pulmonary TB. The median length of time from symptom onset to treatment was 163 days, while endometrial TB had an average delay to diagnosis of 564 days. Approximately half of patients with UGTB were culture positive (51.4%). However, 70% of early morning urines (EMUs) sent in urinary TB were culture positive. 11 patients (30.6%) underwent two or more invasive procedures, such as biopsy to obtain specimen samples. The mean treatment length for all UGTB cases was 7.3 months (SD 3.1). Notably, 25% of patients with endometrial TB required surgery despite antituberculous treatment. CONCLUSIONS: UGTB is challenging to diagnose as early disease is often asymptomatic. Clinicians faced with non-specific symptoms, or features suggestive of urogenital malignancy amongst patients from TB-endemic areas, should maintain a high suspicion of UGTB.


Assuntos
Diagnóstico por Imagem/métodos , Tuberculose Urogenital/diagnóstico , Adulto , Biópsia , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Tuberculose Urogenital/diagnóstico por imagem , Tuberculose Urogenital/patologia , Sistema Urinário/diagnóstico por imagem , Sistema Urinário/microbiologia , Sistema Urinário/patologia
3.
Rev Bras Ginecol Obstet ; 41(9): 575-578, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31480076

RESUMO

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. According to data from the World Health Organization, this disease remains one of the leading causes of death worldwide. Although it most commonly affects the lungs, tuberculosis can compromise any organ. The present study reports a rare case of vulvar tuberculosis in a postmenopausal woman with a history of asymptomatic pulmonary and pleural tuberculosis, with no prior documented contact with the bacillus. Diagnosis was based on vulvar lesion biopsies, with histological findings suggestive of infection and isolation of M. tuberculosis by microbiological culture and polymerase chain reaction (PCR) essays. The lesions reverted to normal after tuberculostatic therapy.


A tuberculose é uma doença infeciosa causada pelo Mycobacterium tuberculosis. De acordo com dados da Organização Mundial de Saúde, esta doença mantém-se entre as principais causas de morte no mundo. Embora afete mais frequentemente os pulmões, a tuberculose pode comprometer qualquer órgão. O presente artigo relata um caso raro de tuberculose vulvar numa mulher na pós-menopausa, com antecedentes de tuberculose pleural e pulmonar assintomática, sem contato documentado com o bacilo. O diagnóstico foi feito com base na biópsia da lesão vulvar, com achados histológicos sugestivos da infeção e isolamento do M. tuberculosis por meios de cultura e pela técnica da reação em cadeia da polimerase (PCR). Após terapêutica tuberculostática, as lesões reverteram.


Assuntos
Doenças Urogenitais Femininas , Tuberculose Pulmonar/complicações , Tuberculose Urogenital , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Feminino , Doenças Urogenitais Femininas/diagnóstico , Doenças Urogenitais Femininas/tratamento farmacológico , Doenças Urogenitais Femininas/patologia , Humanos , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Urogenital/diagnóstico , Tuberculose Urogenital/tratamento farmacológico , Tuberculose Urogenital/patologia , Vulva/patologia
4.
Rev. bras. ginecol. obstet ; 41(9): 575-578, Sept. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1042337

RESUMO

Abstract Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. According to data from the World Health Organization, this disease remains one of the leading causes of death worldwide. Although it most commonly affects the lungs, tuberculosis can compromise any organ. The present study reports a rare case of vulvar tuberculosis in a postmenopausal woman with a history of asymptomatic pulmonary and pleural tuberculosis, with no prior documented contact with the bacillus. Diagnosis was based on vulvar lesion biopsies, with histological findings suggestive of infection and isolation of M. tuberculosis by microbiological culture and polymerase chain reaction (PCR) essays. The lesions reverted to normal after tuberculostatic therapy.


Resumo A tuberculose é uma doença infeciosa causada pelo Mycobacterium tuberculosis. De acordo com dados da Organização Mundial de Saúde, esta doença mantém-se entre as principais causas demorte nomundo. Embora afetemais frequentemente os pulmões, a tuberculose pode comprometer qualquer órgão. O presente artigo relata um caso raro de tuberculose vulvar numa mulher na pós-menopausa, com antecedentes de tuberculose pleural e pulmonar assintomática, sem contato documentado com o bacilo. O diagnóstico foi feito com base na biópsia da lesão vulvar, com achados histológicos sugestivos da infeção e isolamento do M. tuberculosis pormeios de cultura e pela técnica da reação em cadeia da polimerase (PCR). Após terapêutica tuberculostática, as lesões reverteram.


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Tuberculose Urogenital/diagnóstico , Tuberculose Urogenital/patologia , Tuberculose Urogenital/tratamento farmacológico , Doenças Urogenitais Femininas/diagnóstico , Doenças Urogenitais Femininas/patologia , Doenças Urogenitais Femininas/tratamento farmacológico , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Vulva/patologia , Antituberculosos/uso terapêutico
5.
J Microbiol Immunol Infect ; 52(2): 312-319, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30472096

RESUMO

BACKGROUND: Genitourinary tuberculosis (GUTB) is rare but fatal if not diagnosed early. The purpose of this study was to investigate the outcomes of GUTB in Taiwan. METHODS: We retrospectively reviewed medical records of 57 patients who were diagnosed as GUTB from January 2002 to December 2016, over a 15-year period. Demographic data and clinical manifestations were recorded for analysis. RESULTS: There were 37 males and 20 females with a median age of 71 years. Kidney (24.6%) was the most involved organ. Fever (56.1%) was the major presentation. Sixteen (28.1%) patients presented unfavorable outcome. Compared with the favorable outcome group, the unfavorable outcome group had more malignancy (p = 0.013), fever (p = 0.020), anemia (p = 0007), thrombocytopenia (p = 0.003), and hypoalbuminemia (p = 0.015). In a multivariate analysis, fever (odds ratio: 42.716, 95% confidence interval: 1.032-1767.569; p = 0.048) was identified as prognostic factors for unfavorable outcome. CONCLUSION: GUTB is often in advanced stages with a high mortality in Taiwan. Establishing a diagnosis is difficult and requires thorough investigation. Fever is associated with unfavorable outcome.


Assuntos
Hospitais de Ensino , Tuberculose Urogenital/tratamento farmacológico , Tuberculose Urogenital/epidemiologia , Tuberculose Urogenital/patologia , Tuberculose Urogenital/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/epidemiologia , Antituberculosos/farmacologia , Antituberculosos/uso terapêutico , Feminino , Febre/epidemiologia , Humanos , Hipoalbuminemia/epidemiologia , Estimativa de Kaplan-Meier , Nefropatias/epidemiologia , Nefropatias/microbiologia , Modelos Logísticos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mortalidade , Análise Multivariada , Neoplasias/epidemiologia , Neoplasias/microbiologia , Razão de Chances , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia , Trombocitopenia/epidemiologia , Resultado do Tratamento , Sistema Urinário/cirurgia
7.
Urologiia ; (3): 29-32, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26390556

RESUMO

UNLABELLED: The fourth, terminal, stage of bladder tuberculosis (BT) manifests itself in irreversible changes and requires surgical treatment. OBJECTIVE: To identify the reasons for delayed diagnosis of this urogenital tuberculosis complication. Medical history of 26 urogenital tuberculosis patients with a complicated form of stage 4 BT, referred to the Novosibirsk TB Research Institute for reconstructive surgery were analysed. In 22 patients, bladder volume ranged from 55 to 100 ml, 4 patients previously underwent cystostomy due to extremely small bladder volume. Average duration of BT hidden in the guise of "urogenital infection" was 6.2 years. Patients were treated with norfloxacin (a total of 104 courses), ciprofloxacin (86 courses), amikacin (43 courses), nitroxoline (27 courses), third generation cephalosporins (32 courses), lomefloxacin (17 courses), levofloxacin (11 courses), Amoxicillin clavulanate (4 courses), ampicillin (2 courses). It was demonstrated that all cases of BT stage 4 were iatrogenic. Irreversible debilitating complications occurred due to suboptimal therapy, primarily due to administration of amikacin and fluoroquinolones for urogenital infections, which was tuberculosis in disguise. Absence of M. tuberculosis growth does not exclude tuberculosis; pathological specimens must be further examined at least by PCR. Interventional material must be mandatory examined histologically and stained by Ziehl-Neelsen method to identify M. tuberculosis. Effective and not masking tuberculosis, optimal therapy for urogenital infections includes fosfomycin, furazidin (nitrofurantoin), gentamicin, III generation cephalosporins (in outpatient settings dispersible form of efixime should be preferable).


Assuntos
Diagnóstico Tardio , Tuberculose Urogenital/microbiologia , Doenças da Bexiga Urinária/microbiologia , Antituberculosos/administração & dosagem , Antituberculosos/uso terapêutico , Cistite/microbiologia , Diagnóstico Diferencial , Feminino , Humanos , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Índice de Gravidade de Doença , Tuberculose Urogenital/tratamento farmacológico , Tuberculose Urogenital/patologia , Tuberculose Urogenital/cirurgia , Doenças da Bexiga Urinária/tratamento farmacológico , Doenças da Bexiga Urinária/patologia , Doenças da Bexiga Urinária/cirurgia
9.
Expert Rev Anti Infect Ther ; 12(5): 633-47, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24717112

RESUMO

Extrapulmonary tuberculosis (EPTB) accounts for a significant proportion of tuberculosis cases worldwide. Nevertheless, the diagnosis is often delayed or even missed due to insidious clinical presentation and poor performance of diagnostic tests. Culture, the classical gold standard for tuberculosis, suffers from increased technical and logistical constraints in EPTB cases. In this review the authors outline current diagnostic options for the main forms of EPTB. The authors also discuss the opportunities and challenges linked in particular to microbiological diagnostics and to the attempts to find a new gold standard test for EPTB. Finally, new biomarkers and tests currently under evaluation are hopefully on the way to introduce significant improvements in EPTB diagnosis, for which clinical suspicion will nevertheless be essential.


Assuntos
Tuberculose do Sistema Nervoso Central/diagnóstico , Tuberculose dos Linfonodos/diagnóstico , Tuberculose Osteoarticular/diagnóstico , Tuberculose Pleural/diagnóstico , Tuberculose Renal/diagnóstico , Tuberculose Urogenital/diagnóstico , Antígenos de Bactérias/análise , DNA Bacteriano/isolamento & purificação , Diagnóstico Diferencial , Humanos , Microscopia , Mycobacterium tuberculosis/isolamento & purificação , Mycobacterium tuberculosis/fisiologia , Tuberculose do Sistema Nervoso Central/microbiologia , Tuberculose do Sistema Nervoso Central/patologia , Tuberculose dos Linfonodos/microbiologia , Tuberculose dos Linfonodos/patologia , Tuberculose Osteoarticular/microbiologia , Tuberculose Osteoarticular/patologia , Tuberculose Pleural/microbiologia , Tuberculose Pleural/patologia , Tuberculose Renal/microbiologia , Tuberculose Renal/patologia , Tuberculose Urogenital/microbiologia , Tuberculose Urogenital/patologia
10.
Urologiia ; (1): 13-6, 2013.
Artigo em Russo | MEDLINE | ID: mdl-23662488

RESUMO

In order to analyze the structure of urogenital tuberculosis, retrospective analysis of medical records of 131 patients with newly diagnosed urogenital tuberculosis observed in the Novosibirsk Regional TB Dispensary from 2009 to 2011 was performed. The renal tuberculosis is main form in the structure is urotuberculosis, detected in 75% of patients, and widespread destructive forms of the disease were diagnosed in more than half of cases. Isolated nephrotuberculosis was more often diagnosed in women--56.8%. 15.9% of patients had asymptomatic nephrotuberculosis; one-third of patients complained of pain in the lumbar region and frequent painful urination (35.2 and 39.8%, respectively); symptoms of intoxication were present in 17% of patients, renal colic--in 9.1%, and gross hematuria--in 7.9% of patients. Mycobacteriuria in isolated nephrotuberculosis was detected in 31.8% of cases. Acute tuberculous orchiepididymitis developed in 35.7% of patients, hemospermia was observed in 7.1% of patients, dysuria was in 35.7% of patients. The pain in the perineum, frequent painful urination (both by 31.6%), hemospermia (26.3%) were main complaints in prostate tuberculosis. Mycobacteria was detected in 10.5% of cases. It was found that urogenital tuberculosis has no pathognomonic symptoms; the most alarming manifestations include long-term dysuria, hematuria, hemospermia.


Assuntos
Tuberculose Urogenital/epidemiologia , Tuberculose Urogenital/fisiopatologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Hematúria/epidemiologia , Hematúria/etiologia , Hematúria/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Dor/patologia , Dor/fisiopatologia , Cólica Renal/epidemiologia , Cólica Renal/etiologia , Cólica Renal/fisiopatologia , Estudos Retrospectivos , Fatores Sexuais , Sibéria/epidemiologia , Fatores de Tempo , Tuberculose Urogenital/complicações , Tuberculose Urogenital/patologia , Transtornos Urinários/epidemiologia , Transtornos Urinários/etiologia , Transtornos Urinários/fisiopatologia
13.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.) ; 35(6): 298-300, jun.-jul. 2009. ilus
Artigo em Espanhol | IBECS | ID: ibc-140865

RESUMO

El tracto urogenital es una de las localizaciones más frecuentes de tuberculosis extrapulmonar, pero no es un hallazgo muy común en nuestra práctica clínica. En este tracto, la tuberculosis epididimaria, aunque rara, puede ser la primera y única localización clínica evidente de infección tuberculosa. Presentamos el caso de un varón de 67 años de edad con una masa paratesticular, cuyo estudio histopatológico reveló una epididimitis de origen tuberculoso. El paciente no refería antecedentes de tuberculosis y ninguna de las pruebas complementarias realizadas mostró evidencia de infección tuberculosa, pasada o actual (AU)


The urogenital tract is one of the most common sites of extrapulmonary tuberculosis, however, it is not a very common finding in our clinical practice. In this tract, epididymal tuberculosis, although rare, may be the initial and only clinically manifest location of tuberculous infection. We present the case of a 67-year-old male with paratesticular tumor, whose histopathology analysis showed tuberculous epididymitis. The patient reported no background of tuberculosis and none of the other complementary tests performed showed any evidence of past or current tuberculosis infection (AU)


Assuntos
Humanos , Masculino , Tuberculose/genética , Tuberculose/metabolismo , Tuberculose Urogenital/metabolismo , Tuberculose Urogenital/patologia , Atenção Primária à Saúde , Preparações Farmacêuticas/administração & dosagem , Tuberculose/classificação , Tuberculose/fisiopatologia , Tuberculose Urogenital/complicações , Tuberculose Urogenital/diagnóstico , Atenção Primária à Saúde/métodos , Preparações Farmacêuticas
14.
Andrologia ; 41(2): 130-5, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19260851

RESUMO

Genitourinary tuberculosis (TB) is the most frequent manifestation of extrapulmonary TB, where the epididymides, seminal vesicles and prostate are the commonly infected sites, followed by the testes. We report a 29-year-old man who presented with primary infertility since 2 years. He had a history of bilateral painful scrotal swelling with fever since 4 years, diagnosed as pyogenic scrotal abscess, which was managed by incision and drainage. At presentation, fever, weight loss and night sweats were absent. On examination, he had ovoid slightly tender, firm to hard irregular masses in the lower poles of both testes with no line of separation encroaching on both epididymes. Both testes were not felt distinctly and the overlying scrotal skin showed no signs of inflammation. Semen analysis revealed azoospermia. Scrotal colour coded duplex ultrasonography demonstrated moderately enlarged testes having well defined hypoechoic masses with foci of calcifications. Magnetic resonance imaging confirmed these findings. Biopsy and histopathology detected the presence of caseating granuloma and Ziehl-Neelsen staining of paraffin sections demonstrated acid-fast bacilli. The patient was treated with combination therapy. Tracing of the condition is discussed.


Assuntos
Doenças Testiculares/patologia , Testículo/patologia , Tuberculoma/patologia , Tuberculose Urogenital/patologia , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças Testiculares/diagnóstico por imagem , Testículo/diagnóstico por imagem , Tuberculoma/diagnóstico por imagem , Tuberculose Urogenital/diagnóstico por imagem , Ultrassonografia
15.
Infect Dis Obstet Gynecol ; 2008: 817515, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18301724

RESUMO

Tuberculosis of the female external genitalia is unusual and primary infection is rare. We report a 50-year-old female patient admitted to Department to Surgery with swelling over left inguinal area with discharging sinus from labia majora to left inguinal crease which was found to be tubercular sinus on histopathology.


Assuntos
Tuberculose Urogenital/microbiologia , Vulva/microbiologia , Doenças da Vulva/microbiologia , Feminino , Humanos , Pessoa de Meia-Idade , Tuberculose Urogenital/patologia , Tuberculose Urogenital/cirurgia , Vulva/patologia , Doenças da Vulva/patologia
16.
Fertil Steril ; 89(3): 701-2, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18022170

RESUMO

Hysteroscopic visualization of the endometrium after 6 months of antitubercular therapy showed an improvement in the mucosal morphology. A closer visualization at increased magnification was helpful in demonstrating the remnants of a healing tubercular pathology after antitubercular therapy.


Assuntos
Antituberculosos/uso terapêutico , Endométrio/patologia , Histeroscopia , Tuberculose Urogenital/tratamento farmacológico , Doenças Uterinas/tratamento farmacológico , Adulto , Feminino , Humanos , Nascido Vivo , Mucosa/patologia , Gravidez , Resultado do Tratamento , Tuberculose Urogenital/patologia , Doenças Uterinas/patologia
18.
Nat Clin Pract Urol ; 4(4): 227-30, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17415355

RESUMO

BACKGROUND: A 38-year-old man presented with bilateral testicular swelling, night sweats and weight loss with little response to antibiotics. Examination revealed systemic lymphadenopathy and multiple small masses arising from both testes. INVESTIGATIONS: Scrotal ultrasound revealed multiple intratesticular, hypoechoic lesions; chest radiograph and abdominal ultrasound were normal. A CT scan revealed multilevel lymphadenopathies. A Heaf (tuberculin) skin test was negative. Testicular biopsy revealed multiple granulomata, some of which showed patchy central necrosis. DIAGNOSIS: A diagnosis of tuberculosis was initially made. After 3 months of clinical deterioration despite antitubercular drug therapy, however, the diagnosis was changed to sarcoidosis because blood results revealed hypercalcemia, elevated serum angiotensin-converting enzyme, and an elevated erythrocyte sedimentation rate. MANAGEMENT: The patient improved dramatically on corticosteroid therapy, with complete regression of all testicular lesions on imaging after 2 months. Steroids were tapered, then discontinued after 6 months. The patient remained in complete remission, but became oligospermic by the 3 year follow-up.


Assuntos
Sarcoidose/patologia , Escroto/patologia , Tuberculose Urogenital/patologia , Corticosteroides/uso terapêutico , Adulto , Antituberculosos/uso terapêutico , Biópsia por Agulha , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Masculino , Medição de Risco , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Tomografia Computadorizada por Raios X , Tuberculose Urogenital/diagnóstico , Tuberculose Urogenital/tratamento farmacológico , Ultrassonografia Doppler
19.
Afr. j. urol. (Online) ; 13(2): 145-150, 2007.
Artigo em Francês | AIM (África) | ID: biblio-1258055

RESUMO

Objectif : Rapporter les particularites epidemiologiques; anatomo-cliniques; pronostiques et therapeutiques de l'atteinte genitale masculine de la tuberculose avec revue de la litterature. Patients et methodes : Il s'agit d'une etude retrospective portant sur 22 cas de lesions genitales de tuberculose confirmees. Le diagnostic a ete pose sur un faisceau d'arguments cliniques; bacteriologiques; radiologiques et histologiques. Un traitement anti-tuberculeuse a ete instauree systematiquement. La surveillance a ete clinique; biologique et radiologique. Resultats: Les motifs de consultation ont ete par ordre de frequence decroissant : l'epididymite chronique (11 cas); une fistule scrotale (6 cas); une hydrocele (6 cas); une retention d'urine (3 cas) et une sterilite (1 cas). L'examen clinique a retrouve un nodule epididymaire dans 11 cas et une hydrocele dans 10 cas. Une leucocyturie sans germe a ete retrouvee dans un cas. L'echographie scrotale realisee a mis en evidence des lesions epididymaires dans 8 cas. Le diagnostic de certitude a ete pose sur l'examen anatomopathologique des pieces operatoires (13 cas); de fragments biopsiques (8 cas); et par la decouverte du bacille de Koch dans les urines (1 cas). L'urographie intraveineuse realisee systematiquement a retrouve des lesions urinaires associees dans 5 cas. L'evolution a ete favorable dans tous les cas.Conclusion: L'atteinte tuberculeuse isolee des organes genitaux masculins est de diagnostic difficile en dehors d'un contexte endemique tuberculeux. Une etiologie tuberculeuse doit etre suspectee devant toute orchiepidydimite trainante; particulierement sur terrain debilite ou devant une notion d'hypofertilite. Le traitement medical reste efficace en cas de diagnostic precoce; alors que la chirurgie est reservee aux cas resistants ou compliques


Assuntos
Antituberculosos , Prostatite , Tuberculose Urogenital , Tuberculose Urogenital/epidemiologia , Tuberculose Urogenital/patologia
20.
J Microbiol Immunol Infect ; 39(5): 408-13, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17066204

RESUMO

BACKGROUND AND PURPOSE: Genitourinary tuberculosis is the second most common disease form of extrapulmonary tuberculosis. This study analyzed the clinical characteristics and outcome in 31 patients with genitourinary tuberculosis treated between 1994 and 2004 at a tertiary medical center in southern Taiwan. METHODS: Data were collected by chart review. Diagnosis was based on microbiological or histological proof plus compatible radiographic findings and clinical presentation. RESULTS: This study included 14 men (45%) and 17 women (55%). Their ages ranged from 31 to 81 years (mean, 58.1 years). Genitourinary symptoms (83.9%) were more frequent than constitutional symptoms (35.5%). Pyuria plus hematuria with sterile culture (51.6%) was the most common finding. Only 25.8% of patients had a known history of pulmonary tuberculosis. Diagnosis was based on microbiological findings in 11 patients (35.5%), and by histological findings in 20 (64.5%) patients. Intravenous pyelography revealed abnormalities in 94% of patients and renal ultrasonography in 79.2%. Imaging studies were characteristic of advanced stage in most patients. Twenty-five percent of patients were classified as having treatment failure after at least 6 months of therapy. The treatment failure rate was higher in patients with positive microbiological findings (71.4%) than in those with histological findings alone (5.9%, p=0.003). CONCLUSIONS: The high rate of treatment failure and advanced stage of disease at diagnosis are indicative of the challenge in the care of patients with genitourinary tuberculosis in Taiwan.


Assuntos
Tuberculose Urogenital/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Feminino , Hematúria/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Piúria/patologia , Estudos Retrospectivos , Taiwan , Tuberculose Pulmonar/complicações , Tuberculose Urogenital/complicações , Tuberculose Urogenital/tratamento farmacológico , Tuberculose Urogenital/microbiologia
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