A MAN was diagnosed with a rare form of the ‘world’s deadliest disease’ – after his left testicle swelled to 15cm and started leaking pus.
The 41-year-old had been suffering swelling in his scrotum for eight weeks before going to hospital.
Doctors at the department of urology at the Ibn Sina University Hospital in Rabat, Morocco, diagnosed the man with genitourinary tuberculosis – a rare type of tuberculosis (TB) that affects the genitals and urinary tract.
TB is a bacterial infection that usually affects the lungs, but it can infiltrate other body parts too.
The illness tends to spread through droplets released by the coughs and sneezes of people infected with TB – though studies have suggested speaking and breathing might be enough to spew bug-laced germs into the air.
TB is regarded as one of the deadliest infectious diseases, surpassing Covid to become the leading cause of death in 2023 as it wiped out the lives of 1.25 million worldwide.
“In Morocco, TB is endemic, with an incidence of 97 cases per 100,000 people annually,” medics wrote in a paper published to Urology Case Reports.
The deadly Victorian disease has recently seen a resurgence in England, with officials urging Brits to be vigilant about its symptoms.
The latest figures from the UK Health Security Agency showed cases jumped by more than 11 per cent, rising from 4380 in 2022 to 4855 in 2023.
If they aren’t infecting the lungs, TB bacteria tend to crop up in organs such as the kidneys.
Genitourinary tuberculosis (GUTB) makes up about 20 per cent of extrapulmonary TB cases – when the TB infects parts of the body other than the lungs.
It’s even rarer for the bacteria to infect the testicles, occurring in only 2 to 4 per cent of GUTB cases.
The 41-year-old patient from Morocco was seen by urologists after suffering swelling to his left testicle for eight weeks.
“The mass had progressively increased in size, reaching a diameter of 15 cm,” medics wrote.
His swollen scrotum had also started leaking a thick, milky fluid three weeks beforehand.
Doctors suspected he might have TB, but the man reported no symptoms – such as fever, cough, night sweats or weight loss – suggesting the infection had originated in his lungs.
Chest X-rays also came back normal.
The man said he hadn’t been exposed to TB in the past, nor had he experienced other urinary symptoms or injury to his scrotum.
Doctors also conducted a physical examination of their patient, reporting that his left testicle was “firm, irregular, and non-tender, while the right testis was normal”.
An ultrasound showed that “the scrotal wall appeared thickened with infiltration of the surrounding tissues”, while a CT scan showed that the man’s bladder and kidney hadn’t been infected with TB.
The tuberculosis symptoms to watch out for
TB is a potentially serious condition, but it can be cured if it's treated with the right antibiotics.
It normally affects the lungs, but it can also affect other parts of the body, including the bones, brain, lymph glands, kidneys, spine, skin, and stomach.
If you have TB in your lungs, the most common symptoms are:
- A persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
- Breathlessness that gradually gets worse
- Lack of appetite and weight loss
- A high temperature
- Night sweats
If you have TB in other parts of your body, you may have symptoms such as:
- Swollen glands
- Body ache
- Swollen joints
- Tummy ache
- Dark pee
- Headaches
- Being sick
- Feeling confused
- A stiff neck
- A rash
Source: Asthma and Lung UK
As medics were concerned the swelling on the man’s testicle might become cancerous or spread to other parts of the body, they decided to proceed with surgically removing it.
During the surgery, they found that the man’s testicle was “grossly enlarged with a necrotic, heterogeneous appearance”.
The man went on a course of anti-TB drugs for six months.
“The patient tolerated the treatment well, and no significant side effects were reported,” the report authors said.
But follow-up testing showed that his brush with TB had left his fertility “permanently impaired”, as there was no sperm in his semen.
“Fertility concerns are significant in testicular tuberculosis,” medics said.
TB is treatable with a six-month course of antibiotics.
It’s important to take your antibiotics correctly and until you’ve completed the course, even if you feel better.
If you stop your treatment early, TB could come back.
Left untreated the disease can spread to others parts of the body and can prove fatal.
