International Medical Case Reports Journal (Mar 2021)
Drug-Resistant Tuberculosis Presenting as a Testicular Mass: A Case Report
Abstract
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 [email protected]: 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
