Prostatitis

Prostatitis, Tuberculous

genitourinary tuberculosis, GU tuberculosis, genitourinary TB, tuberculous prostatitis, tuberculosis, prostatic urethral TB, Mycobacterium tuberculosis, M tuberculosis, TB, prostatic TB, prostatic tuberculosis, phthisis,prostatic urethral tuberculosis, prostatic parenchymal tuberculosis, prostatic parenchymal TB, consumption, tuberculous prostatic abscess

Background

Tuberculosis (TB) has plagued humankind since antiquity. The effects of TB have been noted in skeletal remains from 4000 BC.

The disease continues to pose a major worldwide health problem despite optimistic predictions of the eradication of TB in developed nations, .

Physical

• Prostatic TB should be suspected in patients who have a draining perineal fistula.
• In patients with a prostatic tuberculous abscess, a soft fluctuant mass has been noted.
• Tenderness varies with the acuity of the process.
• Most patients with prostatic TB in contemporary series have a prostate that may be hard, irregular, nodular, or granular.

 

Differentials

Chronic Bacterial Prostatitis
Churg-Strauss Syndrome
Blastomycosis
Urinary Tract Infection, Males
Wegener Granulomatosis
Cryptococcosis
Eosinophilic Granuloma (Histiocytosis X)
Epididymitis
Urethral Cancer
Urethral Strictures
Interstitial Cystitis
Prostate Hyperplasia, Benign
Prostatitis, Bacterial
Candidiasis
Infertility
Infertility, Male
Urethritis
Actinomycosis
Acute Bacterial Prostatitis and Prostatic Abscess

Treatment

the treatment of tuberculous prostatitis is similar to that of other tuberculous infections. Patients should be isolated in a negative-pressure room, if available. Drug susceptibility testing should be performed on the isolates obtained from the prostate. In addition, the local health department should be notified to aid in identifying patient contacts.