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The penile lesion originally started as a small ulcer on the dorsal aspect of the glans penis which slowly and progressively enlarged and this was ensued by the development of multiple variably sized nodules on the ulcerated glans penis. On clinical examination he was found to have a tender and firm cauliflower growth with nodular surface which had occupied the entire glans penis (see Figure 1). With regard to management of the two cases, both patients were treated with rifampicin, pyrazinamide, ethambutol, and isoniazid (INH).The growth had encompassed the external urethral meatus which was hidden beneath the growth. Clinically the lesion was described as mimicking carcinoma of penis. After two months, pyrazinamide and ethambutol were stopped but the remaining two antitubercular drugs were continued for 7 months.
Diagnosis is established by microscopic examination finding of granulomas /−AFB in penile discharge or biopsy of lesion or culture of Tb organism from discharge or biopsy specimens or positive Elisa serology/PCR for Tb. Tuberculosis [Tb] is the most widespread and persistent human infection in the world.
TBP presents with a painless/painful small nodule, ulcer, mass on penis which gradually enlarges, and induration/swelling of penis, with or without erectile dysfunction. TBP mimics penile carcinoma, granulomatous syphilis penile ulcer, genital herpes simplex, granuloma inguinale, and HIV infection. Clinicians should consider possibility of PTB in cases of penile lesions and erectile failure.
Ultrasound scan may indicate absence or presence of Tb in the genitourinary tract including the kidney, testis, epididymis, and seminal vesicles of the patients and also their contacts and family and in females, presence or absence of abnormality of the endometrium may be seen.(c) Computed Tomography (CT) Scan.
CT scan of abdomen, pelvis, and thorax when undertaken may confirm or exclude presence or absence of pulmonary Tb in the patient, his contacts, and family. Reproduced with permission granted by the editor of the journal, who stated that permission to make a copy of the paper has been granted subject to the following: (1) the paper should only be used for academic and research purposes and not for profit/business.
CT scan would also confirm or exclude presence of extrapulmonary Tb or enlarged inguinal lymph nodes.(d) Magnetic Resonance Imaging (MRI) Scan. (2) Permission is given with the proviso that the Indian Journal of Tuberculosis is cited as the source of the figure.
MRI scan of abdomen, pelvis, and thorax when undertaken may confirm or exclude presence or absence of pulmonary Tb in the patient, his contacts, and family. The original copy right is retained by Indian Journal of Tuberculosis and any request to use or reproduce the figure would require permission from the Indian Journal of Tuberculosis.
Various internet data bases were searched including the following: PUB Med, Google, Google scholar, and Educus.
The following search words were used: tuberculosis of the penis and penile tuberculosis.
Globally, no country has ever been able to eradicate Tb [2, 4].
PTBs respond to first- or 2nd-line anti-Tb 6-month treatment. The infection can affect any organ and mimic other illnesses; hence it is called the great mimicker [1–3].