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Nakou I, Kotoulas SC, Sionidou M, Daios S, Manika C, Hadji-Mitrova M, Papadaki E, Manika K. Two Cases of Testicular Tuberculosis and Review of the Recent Literature. Int J Mycobacteriol 2024; 13:225-236. [PMID: 39277883 DOI: 10.4103/ijmy.ijmy_130_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/23/2024] [Indexed: 09/17/2024] Open
Abstract
In this review, two cases of testicular tuberculosis (TB) are presented, and another 58 cases published in PubMed between January 1, 2012, and July 31, 2023, are reviewed. Testicular TB remains a disease mainly of the developing world, with one notable exception - the infections caused as a result of Bacillus Calmette-Guérin infusion immunotherapy for bladder cancer. Its clinical course is subacute; however, it might get disseminated and become life-threatening; therefore, prompt diagnosis is very important. The diagnosis can be quite challenging, and testicular tissue is the sample with the highest diagnostic yield, either for microbiological or histopathological diagnosis. On the other hand, its treatment follows the standard guidelines for TB treatment; however, the avoidance of an unnecessary orchiectomy is important.
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Affiliation(s)
- Ifigeneia Nakou
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Serafeim-Chrysovalantis Kotoulas
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Intensive Care Unit, Hippocration General Hospital, Thessaloniki, Greece
| | - Maria Sionidou
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Daios
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina Manika
- Department of Radiology, "Agios Pavlos" General Hospital, Thessaloniki, Greece
| | - Marija Hadji-Mitrova
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Papadaki
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Manika
- Pulmonary Department, Respiratory Infections Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Farias LABG, Vitoriano FES, Ribeiro CKB, Marques de Matos MDF, Perdigão Neto LV, Pires Neto RDJ. Two cases of testicular tuberculosis in HIV patients with distinct clinical presentations. Trop Doct 2024; 54:176-178. [PMID: 38146187 DOI: 10.1177/00494755231220400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Genito-urinary tuberculosis (TB) corresponds to the second most common cause of extrapulmonary tuberculosis EPTB worldwide. It is however rare and is often clinically indistinguishable from testicular malignancy and infarction. HIV hugely increases the risk of TB in unusual sites; we present two such cases of testicular tuberculosis. The diagnosis was based respectively on histopathological findings, acid-bacilli smear of biopsy, semen, and culture.
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Cui J, Li X, Yu Y, Xue F, Tian J, Yan Q. Using ultrasound guided needle biopsy in conjunction with GeneXpert MTB/RIF to diagnose epididymal tuberculosis. Medicine (Baltimore) 2023; 102:e36344. [PMID: 38206740 PMCID: PMC10754575 DOI: 10.1097/md.0000000000036344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/06/2023] [Indexed: 01/13/2024] Open
Abstract
This study aimed to investigate the diagnostic utility of percutaneous ultrasound-guided needle biopsy conjunction with GeneXpert MTB/RIF for epididymal tuberculosis. A retrospective analysis was conducted on the pathological and laboratory examinations of 20 patients with epididymal lesions undergoing ultrasound guided biopsy at Shandong Public Health Clinical Center. Laboratory examination included acid-fast staining, Mycobacterium tuberculosis culture by BACTEC MGIT 960, and GeneXpert MTB/RIF test. Diagnosis and complications were comprehensively analyzed. Among the 20 patients, 15 had epididymal tuberculosis and 5 had non-epididymal tuberculosis. Ten patients had granulomatous inflammation and necrotic tissues. The sensitivity and specificity of acid-fast staining, Mycobacterium tuberculosis culture, and GeneXpert MTB/RIF for the diagnosis of epididymis tuberculosis were 26.67% and 100.00%, 33.33% and 100.00%, and 86.67% and 100.00%, respectively. The diagnostic value analysis of the 3 detection techniques indicated that the GeneXpert MTB/RIF technique (Kappa = 0.765, Area under the curve (AUC) = 0.933) was superior to Mycobacterium tuberculosis culture (Kappa = 0.200, AUC = 0.667) and acid-fast staining (Kappa = 0.154, AUC = 0.633). Ultrasound-guided percutaneous biopsy is a safe procedure. The GeneXpert MTB/RIF test has high sensitivity, specificity, and superior AUC value, which are of great value in the diagnosis of epididymal tuberculosis and rifampicin resistance detection.
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Affiliation(s)
- Jia Cui
- Department of Ultrasound, Shandong Public Health Clinical Center, Shandong University Jinan, Shandong, China
| | - Xiuju Li
- Department of Ultrasound, Shandong Public Health Clinical Center, Shandong University Jinan, Shandong, China
| | - Yong Yu
- Department of Ultrasound Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Feng Xue
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jiakai Tian
- Department of Ultrasound, Shandong Public Health Clinical Center, Shandong University Jinan, Shandong, China
| | - Qinghu Yan
- Department of Ultrasound, Shandong Public Health Clinical Center, Shandong University Jinan, Shandong, China
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Nuwagira E, Yekosani M, Abraham B, Atwine R, Caleb T, Baluku JB. Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report. Int Med Case Rep J 2021; 14:145-149. [PMID: 33688269 PMCID: PMC7936665 DOI: 10.2147/imcrj.s300216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022] Open
Abstract
Background Extrapulmonary drug-resistant tuberculosis is extremely rare and is almost always associated with poor treatment outcomes. This is partly due to the difficulty in confirming the diagnosis. Case Presentation A 40-year-old HIV-negative male presented with a painless scrotal mass, low-grade fever, general malaise, night sweats, and no pulmonary symptoms. He was initially treated for malaria with no improvement. His final diagnosis was rifampicin-resistant tuberculosis following Xpert® MTB/RIF Ultra (Xpert-Ultra) assay performed on a fine needle aspirate of the scrotal mass. Second-line anti-tuberculosis medication was initiated, and the patient is being followed up with directly observed therapy. Conclusion With the scale-up of Gene-Xpert technology, this case raises awareness about tuberculosis masquerading as a testicular mass and the possibility of extrapulmonary drug-resistant tuberculosis in high endemic areas.
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Affiliation(s)
- Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mitala Yekosani
- Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Birungi Abraham
- Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Raymond Atwine
- Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Tuhumwire Caleb
- Department of Surgery, Mbarara University of Science and Technology, Mbarara, Uganda
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