[Multifocal tuberculosis with epididymitis and orchitis in an HIV negative
Diop BM, Soumare M, Manga NM, Niang EH, Badiane MDakar Med. 2002;47(2):147-50..
Clinique des Maladies infectieuses Ibrahima Diop Mar, CHU de Fann- Dakar. bmdiopmi@hotmail.com
This case report try to point out the importance of early diagnosis, and an appropriate treatment in multifocal tuberculosis including a testicular localization. A 25 year-old male with a past history of tuberculosis contact and untreated chronic cough with haemoptysis is admitted in our in-patient clinic. Eighteen months earlier, he presented a long course fever, with lumbar pain. Thereafter, the patient condition worsened as he lost weight and developed an enlargement of the right testicle with an scrotal abscess fistulous and a meningo-encephalitis clinical presentation. The bacilloscopy performed on gastric specimen and scrotal caseous was negative. The cerebrospinal fluid was clear and showed a mixed formula with 370 cells including 50% of lymphocytes, an elevated albumin (0.70g/l) and low glucose (0.10g/l) . Sterile pus was detected in urine. The tuberculosis skin test was positive. In addition to the clinical and epidemiological context, the radiological findings (chest and spine X-ray, testicular ultrasonography, cerebral CT Scan) were consistent with multifocal tuberculosis infection with lung miliary, epididymal-orchitis, and brain tuberculomas. The patient was treated successfully using a two-step protocol: two-month treatment with isoniazid, rifampicin, ethambutol and pyrazinamid altogether; followed by a seven-month regimen with isoniazid and rifampicin. Nevertheless,the patient is likely to develop static trouble and infertility because of the spine sequela and testicle atrophy he presented.
This abstract is being posted for educational purposes, as well as for comment and criticism, by the visitors to the Epididymitis Foundation website (www.EpididymitisFoundation.org ). This abstract is representative of a larger article that is indexed on Medline.
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