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Tuberculosis of Glans Penis: A Case Report
Journal of Clinical Trials

Journal of Clinical Trials
Open Access

ISSN: 2167-0870

+44 20 3868 9735

Case Report - (2018) Volume 8, Issue 4

Tuberculosis of Glans Penis: A Case Report

El Anzi Ouiam1*, Maouni Safae1, Boualaoui Imad2, Zenati Kaoutar3, Meziane Mariam1 and Hassam Badredine1
1Department of Dermatology-Venereology, Ibn sina University Hospital, Mohammed V University, Rabat, Morocco
2Department of Urology A, Ibn sina University Hospital, Mohammed V University, Rabat, Morocco
3Department of Anatomopathology, Ibn sina University Hospital, Mohammed V University, Rabat, Morocco
*Corresponding Author: El Anzi Ouiam, Department of Dermatology-Venereology, Ibn sina University Hospital, Mohammed V University, Rabat, Morocco, Tel: +00 212 6 24 60 41 05 Email:

Keywords: Penile Tuberculosis; Genital ulcer rare; Anti-tuberculous therapy

Introduction

Tuberculosis is a bacterial infectious disease in Mycobacterium tuberculosis .Genitourinary tuberculosis (TB) is a common site for extra pulmonary tuberculosis. But tuberculosis of the penis is an extremely rare entity with few cases described in the literature.

Clinical case

A 43-year-old man presented with complaint of painless and nonhealing lesion over his genitalia for last 13 months. He had no history of any loss of weight in the recent past and He denied extramarital sexual contact or dysuria.

The patient had tried different treatment modalities without any response.

Dermatological examination of the penis found multiple ulcers, some of them confluent, with jagged edges and indurated base.

The rest of the clinical examination objectified bilateral, sensitive and mobile inguinal lymph nodes. Haematological and biochemical examination did not reveal any abnormality.

A Laboratory test for syphilis, serology for HIV and Viral Hepatitis B and C were negative. The histological examination of the ulceration revealed intense granulomatous infiltrate with Langhans giant cells and caseation necrosis, first evoking tuberculosis. Radiological investigations including X-ray chest and ultrasound of the abdomen, to find any collateral evidence of TB, were normal. The patient was treated with anti-bacillary drugs: rifampicin (R), isoniazid (H), pyrazynamide (Z) and ethambutol (E) during two months relayed by a dual therapy combining R and H during four months (Figure 1). The healing of genital ulcer was complete.

clinical-trials-Multiple-ulcers

Figure 1: Multiple ulcers with well-defined irregular margins present all around the glans penis

Comments

TB of the genitourinary tract is the most common site for extra pulmonary disease [1]. But TB of the penis is extremely rare. Very few cases have been described worldwide with less than 1% of all genital TB cases reported [2].

It is classically contracted during a traditional circumcision. Sexual intercourse with a partner with genital or pulmonary tuberculosis has been recently described. Inoculation from contaminated clothing is rare.

The main differential diagnosis is penile carcinoma should be removed by histological examination.

The diagnosis of tuberculosis is based on a bundle of clinical, histological, bacteriological and immunological arguments [3,4]. Localization far from the meatus eliminates an urogenital or periorifical form. Lupus vulgaris is evolving very slowly and is accompanied by progressive tissue destruction (Figure 2).

clinical-trials-Cutaneous-histology

Figure 2: Cutaneous histology (HES, G x 100), epithelioid granuloma with central area of necrosis surrounded by lymphocytes.

Histologically, there is a tuberculoid granuloma but gaseous necrosis is rarely found. The treatment of cutaneous tuberculosis is the same as that of pulmonary tuberculosis using the RHZE association for two months then RH for four months.

Conclusion

Any chronic non-healing ulcer over the penis should arouse a suspicion of tuberculosis, especially in an endemic country like Morocco.

References

  1. Gangalakshmi C, Sankaramahalingam (2016) Tuberculosis of Glans Penis- A Rare Presentation. J Clin Diagn Res 10: PD05-PD06.
  2. Khan D, Choudhary A, Dutta A, Khan I (2016 ) Tuberculosis of the glans penis mimicking as carcinoma. Int J Mycobacteriol 5: 341-342.
  3. Venyo AK (2015) Tuberculosis of the penis: a review of the literature. Scientifica 2015: 601624.
  4. Stockamp NW, Paul S, Sharma S, Libke RD, Boswell JS, et al. (2013) Cutaneous tuberculosis of the penis in an HIV-infected adult. Int J STD AIDS 24: 57-58.
Citation: Ouiam EA, Asmae S, Imad B, Kaoutar Z, Mariam M, et al. (2018) Tuberculosis of Glans Penis: A Case Report. J Clin Trials 8: 354.

Copyright: © 2018 Ouiam EA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.