Lee Ing-Kit, Yang Wen-Chou, Liu Jien-Wei
Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
Am J Trop Med Hyg. 2007 Oct;77(4):714-8.
Twenty-nine adults (mean age, 59.9 +/- 13.5 years) with scrotal tuberculosis (TB) were retrospectively analyzed. The mean interval from emergence of symptoms suggestive of scrotal TB to diagnosis established was 142.44 +/- 227.66 days. Scrotal TB was initially suspected in only five (17.2%) patients, and infection caused by bacteria other than Mycobacterium tuberculosis (55.2%) was the leading presumptive diagnosis. Of 28 patients with chest radiographs available, 7 (25%) disclosed active pulmonary TB, and 9 (32.1%) showed a TB scar. All patients received anti-TB chemotherapy; 20 (69%) additionally underwent surgery. Pathologic examination of resected tissue at therapeutic surgery, biopsy, or polymerase chain reaction assay of urine led to rapid diagnosis of scrotal TB. Although evidence of scrotal TB was easily obtainable, the lack of alertness made clinicians avert from the appropriate diagnostic approaches and rendered a delayed diagnosis. Our report underscores the urgent need for improving clinicians' awareness of scrotal TB.
对29例患有阴囊结核的成年人（平均年龄59.9±13.5岁）进行了回顾性分析。从出现提示阴囊结核的症状到确诊的平均间隔时间为142.44±227.66天。最初仅5例（17.2%）患者怀疑为阴囊结核，而结核分枝杆菌以外的细菌引起的感染（55.2%）是主要的初步诊断。在28例有胸部X线片的患者中，7例（25%）显示活动性肺结核，9例（32.1%）有结核瘢痕。所有患者均接受抗结核化疗；20例（69%）还接受了手术。治疗性手术切除组织的病理检查、活检或尿液聚合酶链反应检测导致阴囊结核的快速诊断。尽管阴囊结核的证据很容易获得，但由于缺乏警觉性，临床医生未采用适当的诊断方法，导致诊断延迟。我们的报告强调迫切需要提高临床医生对阴囊结核的认识。
