A clinicopathologic study of tuberculous epididymo-orchitis in Thailand

• Published in: Southeast Asian journal of tropical medicine and public health Vol. 43; no. 4; pp. 951 - 958
• Main Authors: Suankwan, Ulan, Larbcharoensub, Noppadol, Viseshsindh, Wit, Wiratkapun, Cholatip, Chalermsanyakorn, Panas
• Format: Journal Article
• Language: English
• Published: Thailand Central Coordinating Board, SEAMEO-TROPMED Project 01.07.2012
• Subjects: Adult; Aged; Aged, 80 and over; Epididymis - microbiology; Epididymis - pathology; HIV Infections - complications; Human immunodeficiency virus; Humans; Male; Middle Aged; Mycobacterium tuberculosis; Retrospective Studies; Testicular Diseases - microbiology; Testicular Diseases - pathology; Thailand - epidemiology; Tuberculosis, Male Genital - complications; Tuberculosis, Male Genital - diagnosis; Tuberculosis, Male Genital - epidemiology; Tuberculosis, Male Genital - physiopathology; Tuberculosis, Pulmonary - complications; Thailand
• ISSN: 0125-1562

Tuberculous epididymo-orchitis is an uncommon disease caused by Mycobacterium tuberculosis of the testis and epididymis. We reviewed 25 cases of tuberculous epididymo-orchitis, diagnosed at the Faculty of Medicine Ramathibodi Hospital, Mahidol University between July 2000 and June 2010. The mean age at diagnosis was 54.5 years (range: 30 to 91 years). Cultures from testicular and epididymal tissues were positive for Mycobacterium tuberculosis in 6 cases. The clinical presentations of tuberculous epididymo-orchitis included scrotal mass (80%), scrotal pain (44%), micturition syndrome (8%), urethral discharge (4%), and scrotal fistula (4%). One third of the patients had pulmonary tuberculosis. Four patients (16%) had underlying human immunodeficiency virus infection. Tuberculous epididymo-orchitis should be considered in the patients who present with a scrotal mass. The preoperative differentiation of tuberculous epididymoorchitis from non-tuberculous epididymo-orchitis and testicular tumor is difficult. In patients who have epididymal and testicular lesions, surgical excision provides the diagnosis. Exact histopathologic categorization is important to select appropriate medical therapy.