Kundasamy Preeya, Kemp Ben, Kearns Daniel, McCallum Andrew, Nazir Sarfraz, Lyon Paul C
Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Department of Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
BJR Case Rep. 2022 Oct 20;9(1):20220101. doi: 10.1259/bjrcr.20220101. eCollection 2023 Feb.
Urogenital tuberculosis (UGTB) can affect the entire urinary tract including the kidneys, ureters (strictures), urinary bladder, prostate in addition to involving reproductive tracts. In modern day practice, both ultrasound and cross-sectional imaging play an important role in the radiological diagnosis of UGTB. The sequalae of untreated UGTB is morbid and can lead to end-stage renal failure, infertility, and life-threatening systemic infection. UGTB is less commonly observed in developed countries and may mimic other pathologies including malignancy. Thus, it is important that radiologists consider the differential diagnosis early, particularly individuals with risk factors such as travel to endemic regions, to allow optimal treatment and ensure best prognostic outcomes. UGTB can typically be managed by Infectious Disease clinicians with multidrug chemotherapy. We have presented a case of microbiologically proven extrapulmonary tuberculosis (TB) predominantly involving the genitourinary tract. The response to TB agents and lack of evidence of co-infection with another organism, might suggest this as the first published case of emphysematous tuberculous prostatitis. Emphysematous prostatitis is indicative of a gas-forming infection of the prostate, and is associated with abscess formation in the vast majority of case and is an easily identified radiological feature on CT. It is not a well-recognised feature of infection and thus microbiological diagnosis should be sought to confirm the diagnosis.
泌尿生殖系统结核（UGTB）可累及整个泌尿系统，包括肾脏、输尿管（狭窄）、膀胱、前列腺，此外还可累及生殖系统。在现代医疗实践中，超声和断层成像在UGTB的放射学诊断中都发挥着重要作用。未经治疗的UGTB的后果很严重，可导致终末期肾衰竭、不孕以及危及生命的全身感染。UGTB在发达国家较少见，可能会与包括恶性肿瘤在内的其他疾病相混淆。因此，放射科医生尽早考虑鉴别诊断很重要，尤其是对于有前往流行地区旅行等危险因素的个体，以便进行最佳治疗并确保最佳预后。UGTB通常可由传染病临床医生用多药化疗进行管理。我们报告了一例经微生物学证实的主要累及泌尿生殖道的肺外结核（TB）病例。对结核药物的反应以及缺乏与其他病原体合并感染的证据，可能表明这是首例发表的气肿性结核性前列腺炎病例。气肿性前列腺炎表明前列腺存在产气感染，在绝大多数病例中与脓肿形成有关，并且是CT上易于识别的放射学特征。它不是一种广为人知的感染特征，因此应寻求微生物学诊断以确诊。
