rifampin and Prostatic-Diseases

Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients.. We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

Topics: Adult; Antitubercular Agents; Humans; Immunocompetence; Isoniazid; Male; Mycobacterium tuberculosis; Prostatic Diseases; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Male Genital

To characterize the clinical features of prostatic tuberculosis and to evaluate the short and long-term results of antituberculous chemotherapy.. Eighteen patients (mean age 66.7 +/- 10.2 years) with prostatic tuberculosis were included in this study. The median pretreatment prostate-specific antigen (PSA) level was 2.7 ng/mL (range 0.3 to 31). The PSA level was greater than 4.0 ng/mL in 6 patients (33.3%). Eight patients (44.4%) received a triple-drug regimen of rifampin, ethambutol, and isoniazid for more than 6 months. The mean duration of chemotherapy was 7.6 months (range 6 to 12). Of the 8 patients, 3 underwent chemotherapy longer because of concurrent tuberculosis of other organs. Follow-up studies included digital rectal examination, total PSA determination, and transrectal prostate biopsy.. Ten patients were eligible for regular follow-up. All the patients were symptom free during follow-up. The median length of follow-up was 3.4 years (range 1 to 9). The average number of follow-up transrectal prostate biopsies was 2.4 (range 2 to 3). The follow-up histologic findings showed nodular hyperplasia in 7 patients and chronic inflammatory cell infiltration in 3 patients. No acid-fast bacillus was found in any follow-up specimen. Similarly, subsequent transrectal biopsy showed no relapse after a median length of 3.4 years of follow-up. Of the 6 patients with elevated PSA levels, the post-treatment PSA returned to normal in 3 patients.. Our results suggest that a triple-drug regimen of 6 months' duration can successfully control prostatic tuberculosis. Histologic follow-up is a good method for monitoring the efficacy of treatment. Transrectal prostate biopsy is an important tool for the diagnosis and follow-up of prostatic tuberculosis.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Biopsy; Ethambutol; Follow-Up Studies; Humans; Isoniazid; Male; Middle Aged; Palpation; Prostate-Specific Antigen; Prostatic Diseases; Rifampin; Treatment Outcome; Tuberculosis, Male Genital

A case of prostatic tuberculosis is reported. A 61-year-old male visited our clinic complaining of urinary retention. On digital rectal examination, the prostate was found to be enlarged, hard, and uneven. Transrectal ultrasound revealed a large hypoechoic lesion in the posterior aspect of the prostate. Transrectal ultrasound guided systematic biopsies of the prostate were performed. The specimens obtained from the hypoechoic lesion, were diagnosed histopathologically as prostatitis with epithelioid granuloma, Langhans' type giant cells, and caseous necrosis. Mycobacterium tuberculosis was detected in the physiological saline solution injected into the urethra after prostatic massage. The patient was diagnosed as having prostatic tuberculosis and underwent antituberculotic therapy with INH and RFP. Transrectal ultrasound seemed to be useful in detecting histopathological changes associated with tuberculosis in the prostate.

Topics: Anemia, Refractory, with Excess of Blasts; Antibiotics, Antitubercular; Antitubercular Agents; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Prostatic Diseases; Rifampin; Tuberculosis, Urogenital; Ultrasonography

The authors report a series of 40 cases of genitourinary tuberculosis diagnosed and treated in the department of urology "B" of Avicenne hospital over a 7-year period. The objective of this study is to define the various diagnostic and therapeutic aspects of this disease. The patients were predominantly males (62.5%) with a mean age of 40 years. 25% of cases reported a history of extra-urinary tuberculosis. The very polymorphous clinical presentation is dominated by signs of cystitis (45%). Intravenous urography is frequently suggestive of the diagnosis based on the appearance and multiplicity of the lesions. The radiological lesions most frequently encountered were silent kidney (19 cases) and small tuberculous bladder (11 cases). The definitive diagnosis was established by pathological examination in 38 cases (biopsies, operative specimens, prostatic resection chips) and/or by demonstration of AFB in 2 cases (urine, pus). Tuberculostatic treatment was administered to all patients, either alone (5 cases) or, more usually, in combination with surgical and/or endo-urological treatment (35 cases), reflecting the magnitude and severity of the destructive and scar lesions.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Biopsy; Combined Modality Therapy; Constriction, Pathologic; Cystitis; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Nephrectomy; Prostatic Diseases; Pyrazinamide; Rifampin; Stents; Tuberculosis, Male Genital; Tuberculosis, Renal; Tuberculosis, Spinal; Tuberculosis, Urogenital; Ureteral Diseases; Urinary Bladder Diseases; Urography