rifampin and Penile-Diseases

A case of penis tuberculid (papulonecrotic tuberculid of the glans penis) and its treatment with combination of oral rifampicin (RFP) and injection of an extract from tubercle bacilli (T.B. vaccine) were reported. We also examined the literature and discovered 37 cases of this disease in Japan in the last 10 years (between 1978 and 1987).

Topics: BCG Vaccine; Humans; Male; Middle Aged; Penile Diseases; Rifampin; Tuberculosis, Cutaneous

The advent of antibiotic-coated devices has reduced the rate of inflatable penile prosthesis (IPP) infections; however, this may have altered microbial profiles when infections do occur.. To describe the timing and causative organisms behind infection of infection retardant-coated IPPs in the context of our institution's perioperative antimicrobial protocols.. We retrospectively reviewed all patients undergoing IPP placement at our institution from January 2014 to January 2022. In all patients, perioperative antibiotic administration was congruent with American Urological Association guidelines. Boston Scientific devices are impregnated with InhibiZone (rifampin and minocycline), and all Coloplast devices were soaked in rifampin and gentamicin. Intraoperative irrigation was performed with betadine 5% irrigation prior to November 2016 and with vancomycin-gentamicin solution afterward. Cases involving prosthesis infection were identified, and variables were extracted from the medical record. Descriptive and comparative statistics were tabulated to identify clinical characteristics, including patient comorbidities, prophylaxis regimen, symptom onset, and intraoperative culture result. We previously reported an increased infection risk with Betadine irrigation and stratified results accordingly.. The primary outcome was time to infectious symptoms, while the secondary outcome was description of device cultures at the time of explantation.. A total of 1071 patients underwent IPP placement over 8 years with an overall infection rate of 2.6% (28/1071). After discontinuation of Betadine, the overall infection rate was significantly lower at 0.9% (8/919) with a relative risk of 16.9 with Betadine (P < .0001). Primary procedures represented 46.4% (13/28). Of 28 patients with infection, only 1 had no identified risk factors; the remainder included Betadine at 71% (20/28), revision/salvage procedure at 53.6% (15/28), and diabetes at 50% (14/28). Median time to symptoms was 36 days (IQR, 26-52); almost 30% of patients had systemic symptoms. Organisms with high virulence, or ability to cause disease, were found in 90.5% (19/21) of positive cultures.. Our study revealed a median time to symptoms of just over 1 month. Risk factors for infection were Betadine 5% irrigation, diabetes, and revision/salvage cases. Over 90% causative organisms were virulent, demonstrating a microbial profile trend since antibiotic coating development.. The large prospectively maintained database is a strength along with the ability to follow specific changes in perioperative protocols. The retrospective nature of the study is a limitation as well as the low infection rate, which limits certain subanalyses from being performed.. IPP infections present in a delayed manner despite the rising virulence of infecting organisms. These findings highlight areas for improvement in perioperative protocols in the contemporary prosthetics era.

Topics: Anti-Bacterial Agents; Diabetes Mellitus; Gentamicins; Humans; Male; Penile Diseases; Penile Implantation; Penile Prosthesis; Povidone-Iodine; Retrospective Studies; Rifampin

Topics: Adult; Antitubercular Agents; Ethambutol; Humans; Isoniazid; Male; Penile Diseases; Pyrazinamide; Rifampin; Tuberculosis, Male Genital

Topics: Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Humans; Immunocompromised Host; Isoniazid; Male; Middle Aged; Penile Diseases; Pyrazinamide; Rifampin; Skin Ulcer; Tuberculosis, Male Genital; Vitiligo

Mycobacterium tuberculosis (TB) infection of the penis is a rare but serious problem. We report a case of penile TB in a 75-year-old man who presented with fever and dyspnea. No active lung lesions except pleural and pericardial effusion were found on chest X-ray. Monoclonal gammopathy of undetermined significance was diagnosed after serum and urine electrophoresis studies, and repeated bone marrow studies. Genital examination showed diffuse papulonecrotic skin ulcers involving the whole penile shaft, extending ventrally to the median raphe of the scrotum. Pus smear showed positive acid-fast stain, and culture yielded M. tuberculosis. Culture of pleural and pericardial effusion was also positive for M. tuberculosis. Anti-TB treatment was given with isoniazid, ethambutol, rifampin and pyrazinamide, and the cutaneous lesion was noted to be healed at follow-up 6 months later. Although rare, the possibility of TB as a cause of genital ulcer should be kept in mind.

Topics: Aged; Antitubercular Agents; Ethambutol; Humans; Isoniazid; Male; Mycobacterium tuberculosis; Paraproteinemias; Penile Diseases; Pyrazinamide; Rifampin; Tuberculosis, Cutaneous; Tuberculosis, Male Genital

Topics: Adult; Antibiotics, Antitubercular; Drug Therapy, Combination; Humans; Isoniazid; Male; Middle Aged; Penile Diseases; Pyrazinamide; Rifampin; Tuberculosis, Cutaneous

Topics: Bacteria, Anaerobic; Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Penile Diseases; Rifampin; Ulcer