ISOLATED TUBERCULOUS PROSTATITIS IN A PATIENT WITH BENIGN PROSTATIC HYPERPLASIA COMPLICATED BY EPIDIDYMO-ORCHITIS: A CASE REPORT

Abstract

Background: Genitourinary tuberculosis (GUTB) is a common form of extrapulmonary tuberculosis but remains diagnostically challenging due to its ability to mimic malignancy and nonspecific inflammatory conditions. Prostatic tuberculosis is particularly rare and often underrecognized, leading to delayed treatment and disease progression. Case Presentation: A 64-year-old male with benign prostatic hyperplasia presented with recurrent epididymo-orchitis and abnormal digital rectal examination findings suggestive of prostate malignancy. Multiparametric MRI showed indeterminate prostatic lesions. Histopathology from prostate biopsy and transurethral resection revealed caseating granulomatous prostatitis. Initial refusal of anti-tubercular therapy led to disease progression with bilateral epididymo orchitis and scrotal abscess formation. Urine and pus cartridge-based nucleic acid amplification testing confirmed Mycobacterium tuberculosis without rifampicin resistance. The patient required right orchidectomy and was subsequently treated with standard anti-tubercular therapy, with clinical improvement. Conclusion: This case highlights the protean manifestations of GUTB and underscores the importance of early histopathological and molecular diagnosis to prevent disease progression and avoidable surgical morbidity.