Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report

Edwin Nuwagira,1 Mitala Yekosani,2 Birungi Abraham,2 Raymond Atwine,2 Tuhumwire Caleb,3 Joseph Baruch Baluku4 1Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department o...

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Main Authors: Nuwagira E, Yekosani M, Abraham B, Atwine R, Caleb T, Baluku JB
Format: Article
Language:English
Published: Dove Medical Press 2021-03-01
Series:International Medical Case Reports Journal
Subjects:
Online Access:https://www.dovepress.com/drug-resistant-tuberculosis-presenting-as-a-testicular-mass-a-case-rep-peer-reviewed-article-IMCRJ
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author Nuwagira E
Yekosani M
Abraham B
Atwine R
Caleb T
Baluku JB
author_facet Nuwagira E
Yekosani M
Abraham B
Atwine R
Caleb T
Baluku JB
author_sort Nuwagira E
collection DOAJ
description Edwin Nuwagira,1 Mitala Yekosani,2 Birungi Abraham,2 Raymond Atwine,2 Tuhumwire Caleb,3 Joseph Baruch Baluku4 1Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Surgery, Mbarara University of Science and Technology, Mbarara, Uganda; 4Division of Pulmonology, Mulago National Referral Hospital, Kampala, UgandaCorrespondence: Edwin NuwagiraMbarara University of Science and Technology, P.O Box 1410, Mbarara, UgandaTel +256 779096887Email enuwagira@must.ac.ugBackground: Extrapulmonary drug-resistant tuberculosis is extremely rare and is almost always associated with poor treatment outcomes. This is partly due to the difficulty in confirming the diagnosis.Case Presentation: A 40-year-old HIV-negative male presented with a painless scrotal mass, low-grade fever, general malaise, night sweats, and no pulmonary symptoms. He was initially treated for malaria with no improvement. His final diagnosis was rifampicin-resistant tuberculosis following Xpert® MTB/RIF Ultra (Xpert-Ultra) assay performed on a fine needle aspirate of the scrotal mass. Second-line anti-tuberculosis medication was initiated, and the patient is being followed up with directly observed therapy.Conclusion: With the scale-up of Gene-Xpert technology, this case raises awareness about tuberculosis masquerading as a testicular mass and the possibility of extrapulmonary drug-resistant tuberculosis in high endemic areas.Keywords: drug-resistant tuberculosis, genitourinary tuberculosis, extrapulmonary tuberculosis, tuberculous orchitis, sub-Saharan Africa, Uganda
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spelling doaj.art-f9a1a17c95b94269aa869917e77565db2022-12-21T21:31:25ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2021-03-01Volume 1414514962644Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case ReportNuwagira EYekosani MAbraham BAtwine RCaleb TBaluku JBEdwin Nuwagira,1 Mitala Yekosani,2 Birungi Abraham,2 Raymond Atwine,2 Tuhumwire Caleb,3 Joseph Baruch Baluku4 1Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pathology, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Surgery, Mbarara University of Science and Technology, Mbarara, Uganda; 4Division of Pulmonology, Mulago National Referral Hospital, Kampala, UgandaCorrespondence: Edwin NuwagiraMbarara University of Science and Technology, P.O Box 1410, Mbarara, UgandaTel +256 779096887Email enuwagira@must.ac.ugBackground: Extrapulmonary drug-resistant tuberculosis is extremely rare and is almost always associated with poor treatment outcomes. This is partly due to the difficulty in confirming the diagnosis.Case Presentation: A 40-year-old HIV-negative male presented with a painless scrotal mass, low-grade fever, general malaise, night sweats, and no pulmonary symptoms. He was initially treated for malaria with no improvement. His final diagnosis was rifampicin-resistant tuberculosis following Xpert® MTB/RIF Ultra (Xpert-Ultra) assay performed on a fine needle aspirate of the scrotal mass. Second-line anti-tuberculosis medication was initiated, and the patient is being followed up with directly observed therapy.Conclusion: With the scale-up of Gene-Xpert technology, this case raises awareness about tuberculosis masquerading as a testicular mass and the possibility of extrapulmonary drug-resistant tuberculosis in high endemic areas.Keywords: drug-resistant tuberculosis, genitourinary tuberculosis, extrapulmonary tuberculosis, tuberculous orchitis, sub-Saharan Africa, Ugandahttps://www.dovepress.com/drug-resistant-tuberculosis-presenting-as-a-testicular-mass-a-case-rep-peer-reviewed-article-IMCRJdrug resistant tuberculosisgenitourinary tuberculosisextrapulmonary tuberculosistuberculous orchitissub-saharan africauganda
spellingShingle Nuwagira E
Yekosani M
Abraham B
Atwine R
Caleb T
Baluku JB
Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
International Medical Case Reports Journal
drug resistant tuberculosis
genitourinary tuberculosis
extrapulmonary tuberculosis
tuberculous orchitis
sub-saharan africa
uganda
title Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
title_full Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
title_fullStr Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
title_full_unstemmed Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
title_short Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
title_sort drug resistant tuberculosis presenting as a testicular mass a case report
topic drug resistant tuberculosis
genitourinary tuberculosis
extrapulmonary tuberculosis
tuberculous orchitis
sub-saharan africa
uganda
url https://www.dovepress.com/drug-resistant-tuberculosis-presenting-as-a-testicular-mass-a-case-rep-peer-reviewed-article-IMCRJ
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AT abrahamb drugresistanttuberculosispresentingasatesticularmassacasereport
AT atwiner drugresistanttuberculosispresentingasatesticularmassacasereport
AT calebt drugresistanttuberculosispresentingasatesticularmassacasereport
AT balukujb drugresistanttuberculosispresentingasatesticularmassacasereport