Title: Testicular Tuberculosis: A Case Report
Authors: Dr Mohammed Hidayath Hussain, Dr Mohd Hidayathullah Khan, Dr Shahzad Hussain Arastu, Dr Jaweria Naaz Fatima, Dr Syed Murtuza Naqshbandi
DOI: https://dx.doi.org/10.18535/jmscr/v11i3.16
Abstract
Introduction
Tuberculosis (TB) is a serious public health problem in developing countries, with India bearing highest burden. According to global tuberculosis report 2016 of WHO, TB affects more than 9 million people and causes the death of 1.8 million people each year, especially in developing countries.
Extrapulmonary tb is also growing in incident most common being lymph node tuberculosis followed by pleura, bone and joints and then urogenital tract.(1)
One of the rare forms of tuberculosis isgenitalTB, where in the both genders are affected.
Hematogenous or lymphatic spread is the most common form of spread, while direct contiguity with an intraabdominal or peritoneal focus does occasionally occur.(2)
In case of females’ genital tract involvement frequency of tuberculosis in genital organs is as follows, fallopian tubes 90%, endometrium 50 -60% ovaries 20- 30%, cervix 5-15%,vulva, and vagina 1%.(2) TB epididymitis may manifest as a painful, swollen, acute infection or as abscesses and sinuses.(3)
Furthermore, males with genital tuberculosis may develop scrotal masses.(4) It is believed that sexual transmission is possible because viable bacilli have been found in the semen of patients with pulmonary and prostatic Tb, and this transmission was confirmed testing the individuals via molecular methods, which revealed identical organisms isolated from a couple's endometrial biopsy and penile ulcer.(5) The true incidence to genital TB is unknown. Although studies have showed that people who are suffering from Pulmonary tuberculosis, 20% have urogenital involvement about 15-20% in developing country.(6) (7)
In men with genital TB the most common site of involvement is the epididymis, followed by the seminal vesicles, prostate, testis, and the vas deferens.(8)
Surgical management is often reserved for cases that do not present rapid response and adequate or in those in which the suspicion of malignancy is high.(13)
Extrapulmonary involvement of tuberculosis with isolated epididymal involvement is very rare, and in one study its prevalence was noted in young adults(9)
