A rare case of isolated testicular tuberculosis and review of literature

Abstract

Testicular tuberculosis (TB) is a rare form of genitourinary TB. It is usually presented as painful or painless testicular swelling with or without scrotal ulceration or discharging sinus. Infertility may occur. Epididymal involvement is usually seen in testicular TB. In most cases, genital TB is associated with TB involvement of kidneys or lower urinary tract. Ultrasound (USG) and USG-guided fine needle aspiration cytology of testicular swelling confirm the diagnosis. Anti-TB chemotherapy is the mainstay of treatment to ensure the complete resolution of the lesion. However, in very few cases, orchidectomy is required for both diagnosis and treatment. Here, we report a very rare case of left sided isolated testicular TB in a 20-year-old male who was completely cured with 6 months regimen of anti-TB chemotherapy.

Isolated Testicular Tuberculosis in a 9-Year-Old Boy: An Incidental Finding

“…The index patient was a boy that presented with right irreducible non-progressive painless hemiscrotal swellings, that trans illuminates, with an abnormally large hard testes felt within the size of the swelling, with no systemic symptoms. The diagnosis was secondary hydrocele to rule out a testicular tumour, this presentation supports other literature that states that TB of the genitals could presents as an isolated TB, with the epididymis being the commonest, without urinary symptoms, as a painless mass or hydrocele [3,5,10,11,14]. However it is of interest to note that all these Literature reported cases in men, except for Cabral who reported two cases in children [11].…”

“…Majority of people think that tuberculosis affects only the lungs, but in reality, it can affect almost every part of the body [1]. However, the commonest part of the body it affects is the lungs and extra-pulmonary TB accounts for about 10-15% [2,3]. While genitourinary tuberculosis (GUTB) accounts for up to 30% of extrapulmonary TB, epididymal involvement accounts for only about 20% of GUTB In Extra-pulmonary TB [4].…”

“…Genital TB can affect the whole male genital organs; epididymis, testis, prostate, seminal vesicle, vas deferens, scrotal skin, bulbourethral glands and penis [5]. Genital TB is uncommon, and testicular TB is further rare, comprising only 3% of genital TB [3]. When there is genital TB, the genital organ most affected is the epididymis.…”

“…Almost all the testicular TB clinically mimics other testicular lesions, such as testicular tumor, infarction, or even testicular torsion. Middle-aged males, especially of 20-40 years of age are most commonly affected, and presented with painful or painless scrotal swelling with or without discharging sinus [3]. This makes the diagnosis of testicular and epididymal TB very challenging, especially if it is isolated [6].…”

A Rare Case of Primary Tuberculous Epididymo-Orchitis in a Young Patient.

“…Isolated genital involvement is seen in 28% patients of genitourinary tuberculosis. It is more common in males [5].…”