Md. Sadequr Rahman1, Nazia Choudhury2, M.A. Awal Chowdhury3, Parvej Mia4, Md. Abdullah Sayed5
Associate Professor, Department of Medicine, North East Medical College, Sylhet.
Assistant Professor, Department of Medicine, North East Medical College, Sylhet.
Assistant Professor, Department of Medicine, North East Medical College, Sylhet.
Assistant Professor, Department of Medicine, North East Medical College, Sylhet.
Associate Professor, Department of Psychiatry, North East Medical College, Sylhet.
Abstract
The incidence of tuberculosis (TB) is increasing worldwide, with more than 20% of cases exhibiting extrapulmonary manifestations. Genitourinary tuberculosis, the second most common extrapulmonary clinical manifestation is often nonspecific. There are no specific and sensitive noninvasive investigations to help confirm its diagnosis. Isolated tuberculous epididymitis (ITE), defined as tuberculous epididymitis without clinical evidence of either renal or prostate involvement, is a rare entity among genitourinary tuberculosis. When diagnosed correctly, ITE can be cured with anti-TB medications. However, patients with poor response to medical treatment may require surgery. Here, we report an 18-year-old male who presented with pyrexia of unknown origin for 1 month with loss of appetite and weight loss and treated with several course of antibiotic with no significant clinical improvement later become presented with a new complaint of feeling of a lump in his left testicular region. On physical examination we found non tender mass of left epididymis which was adherent to the testis with irregular surface. Scrotal ultrasonography revealed a mixed echogenic mass lesion at the tail region of left epididymis. FNAC feature is consistent with chronic granulomatous inflammation suggestive of tuberculosis.
Key words: Epididymal TB, Extrapulmonary TB, Genitourinary tuberculosis (GUTB).