Johnson Matthew G, Caplan-Shaw Caralee E, McMacken Michelle
MD, New York Langone Medical Center, Department of General Internal Medicine, New York, NY, USA.
MD, New York Langone Medical Center, Department of Pulmonary and Critical Care Medicine, New York, NY, USA.
Germs. 2014 Jun 2;4(2):41-5. doi: 10.11599/germs.2014.1054. eCollection 2014 Jun.
Genitourinary tuberculosis (TB) is infrequently reported in the United States, but is a common form of extrapulmonary TB that often goes unnoticed due to its insidious and sometimes asymptomatic presentation. Prostate involvement and the development of tuberculous prostatic abscesses have been reported in the literature largely in association with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). We report a case of disseminated TB involving tuberculous prostatic abscesses in a patient without HIV/AIDS, presenting with sepsis and urinary symptoms. This patient had simultaneous prostatic, peritoneal, pulmonary, and likely renal TB, serving as a reminder to clinicians that multi-organ presentations of TB do occur in patients without overt immunosuppressive conditions. This case also highlights the importance of considering the diagnosis of genitourinary TB in patients with risk factors for TB presenting with vague, long-standing urinary symptoms.
泌尿生殖系统结核在美国报道较少,但它是肺外结核的常见形式,因其隐匿性且有时无症状,常未被注意到。文献中报道的前列腺受累及结核性前列腺脓肿的发生主要与人类免疫缺陷病毒(HIV)感染和获得性免疫缺陷综合征(AIDS)有关。我们报告一例无HIV/AIDS的患者发生播散性结核并伴有结核性前列腺脓肿,表现为脓毒症和泌尿系统症状。该患者同时患有前列腺、腹膜、肺部以及可能的肾脏结核,这提醒临床医生,在无明显免疫抑制状况的患者中确实会出现结核的多器官表现。该病例还凸显了对于有结核危险因素且伴有模糊、长期泌尿系统症状的患者,考虑泌尿生殖系统结核诊断的重要性。