Rare Tuberculosis Infection Manifests in Unusual Location
A recent medical case detailed a highly unusual presentation of tuberculosis (TB), highlighting the disease’s potential to affect rarely impacted areas of the body. The case,involving a man who underwent a kidney transplant,involved a penile lesion that ultimately led to the diagnosis of miliary tuberculosis,a severe form of the disease.
The patient initially presented with a reddening lesion on his penis, which doctors initially treated with topical corticosteroids. Though, the condition became even redder. Further examination revealed a history of symptoms including fever, loss of appetite and weight, and night sweats, present for several months. Crucially,the patient had a background as a hunter and butcher,indicating significant and prolonged exposure to animal carcasses.
Subsequent scans of the patient’s abdomen, chest, and pelvic area revealed numerous nodules in his lungs, characteristic of miliary tuberculosis, caused by the bacteria Mycobacterium tuberculosis. The related bacteria, Mycobacterium bovis, typically affects deer and cows.While Mycobacterium can infect any part of the body,infections affecting the pelvic region – and specifically the penis - are exceptionally rare,occurring in less than 1% of cases relating to the genital and urinary tract. The bacteria were identified in both the patient’s respiratory tract and penile tissues,though doctors were unable to precisely identify the species responsible for the infection.
The patient was treated with a long course of intensive anti-tuberculosis medication. Initially, the treatment temporarily worsened the penile lesion, but after ten months, the infection had completely disappeared.
the source of the infection remains unclear. While tuberculosis is generally transmitted through the air, the patient reported no contact with individuals known to be infected. Potential sources under consideration included the transplanted kidney or exposure through his work as a hunter-butcher, where handling animal carcasses could have facilitated bacterial transmission, potentially spreading to the penis during a routine activity like using the toilet.
Despite the patient’s successful recovery,the case underscores the continued global impact of tuberculosis. Public Health France reported approximately 5,000 cases of tuberculosis in France in 2023. However, the World Health Organization (WHO) estimates that no fewer than 11 million people will be infected in 2024 worldwide.While preventable and curable, tuberculosis remains one of the leading causes of death linked to antibiotic resistance.
(Image caption as provided in original text): Scanning electron micrograph of the bacteria Mycobacterium tuberculosis, responsible for tuberculosis. Source: DR.
