Suchergebnisse

La tuberculosis genitourinaria es la segunda forma de presentación más común de tuberculosis extrapulmonar luego del compromiso ganglionar, la epididimitis tuberculosa afecta preferentemente a pacientes con edades comprendidas entre los 30 y 50 años, y al menos un 70% tienen historia previa de tuberculosis pulmonar, la infección tuberculosa del escroto es rara y ocurre en aproximadamente el 7% de los pacientes con tuberculosis por extensión directa desde el epidídimo, planteando problemas de diagnóstico diferencial con procesos más agresivos como las neoplasias testiculares. Reportamos el caso de un hombre de 23 años con masa testicular que emulaba ser de origen neoplásico, llevado a orquidectomía unilateral. La patología describe necrosis y granulomas de caseificación conclusivo para orquiepididimitis tuberculosa, paciente inmunocompetente sin antecedente previo de tuberculosis. ; Genitourinary tuberculosis is the second most common form of extrapulmonary tuberculosis after lymph node involvement; tuberculous epididymitis preferentially affects patients between the ages of 30 and 50 years, and at least 70% have a previous history of pulmonary tuberculosis, tuberculous infection scrotum is rare and occurs in approximately 7% of patients with tuberculosis by direct extension from the epididymis, posing problems of differential diagnosis with more aggressive processes such as testicular tumors. We report the case of a 23-year-old man with a testicular mass that emulated being of neoplastic origin, taken to unilateral orchidectomy. The pathology describes necrosis and caseification granulomas, conclusive for tuberculous orchiepididymitis, an immunocompetent patient with no previous history of tuberculosis.

Comparative study of anti-tuberculosis drugs anti-androgenic effects and effects on testicular CYP2E1 has been performed. Testicular CYP2E1 mRNA and protein expression, serum total testosterone level, fertility and spermatogenesis parameters in male rats under simultaneous and separate administration of ethambutol, isoniazid, rifampin and pyrazinamide have been investigated. Analysis of the obtained data has proved the prominent role of ethambutol and isoniazid in gonadal toxicity of antituberculosis drugs combination. Activation of CYP2Е1-dependent metabolizing systems in testicular steroidogenic cells could stipulate at least a part of ethambutol, isoniazid and anti-tuberculosis drugs combination negative effects on testosterone level and spermatogenesis processes. Mechanisms of spermatogenesis alteration by rifampin and pyrazinamide need to be explored more extensively, but in the light of our observations they do not depend from testicular CYP2E1.