Korean J Transplant.  2023 Nov;37(Suppl 1):S156. 10.4285/ATW2023.F-7429.

Isolated testicular tuberculosis in a kidney transplantation recipient

• Yang J
• Kwon JK
• Lee HJ
• Paek JH
• Kim Y
• Park WY
• Jin K
• Choe M
• Han S

• KMID: 2551776
• DOI: http://doi.org/10.4285/ATW2023.F-7429

Abstract

Genitourinary tuberculosis (Tb) is a rare form of extrapulmonary Tb. Especially, isolated testicular Tb is extremely uncommon. The precise diagnosis of testicular Tb might be challenging due to ambiguous clinical symptoms and imaging test results. Our case involved a 36-year-old male kidney transplantation (KT) patient, presenting with left scrotal pain and tenderness. He had undergone living donor KT 8 years ago and took tacrolimus, mycophenolate mofetil, and prednisolone. Laboratory tests revealed anemia, leukocytosis, and elevated inflammatory markers. Computed tomography showed left scrotal wall thickening and enlargement which means left testicular abscess. We hold mycophenolate mofetil and used intravenous antibiotics. Also, we performed incision and drainage of abscess. Nevertheless, the clinical course did not improve. Thus, we performed radical left orchiectomy and biopsy. Biopsy revealed extensive chronic granulomatous inflammation with caseous necrosis, consistent with tuberculous orchiepididymitis. Quadruple anti-Tb drug was given, and the patients clinical course has been improved. This is the first case of testicular Tb in KT recipients. It is necessary to include testicular Tb in the differential diagnosis of testicular infection and mass to prevent unnecessary surgical intervention.