Rare Case of Tuberculosis Infecting the Penis Sparks Attention
289Most people think of tuberculosis (TB) as a lung disease, but it can infect other parts of the body too. Still, having TB on the penis is extremely rare. Recently, a man in Ireland developed this unusual infection, and his case highlights how TB can sometimes surprise us.
A 57-year-old man went to the hospital with a swollen, red, and painful penis that worsened over a week. He also had a fever. His medical history included a kidney transplant 15 years earlier, so he was on medications that suppressed his immune system. This made him more vulnerable to infections. Doctors initially suspected a bacterial skin infection and treated him with antibiotics. But his condition didn’t improve, prompting further investigation.
Uncovering a Rare Tuberculosis Infection
The doctors looked deeper into his symptoms. Over the past few months, the man had experienced night sweats, chills, weight loss, and a loss of appetite. He also worked handling dead animals, including deer and cattle, as he was a hunter and butcher. His exposure to animals raised suspicion of zoonotic infections—diseases that can transfer from animals to humans.
To find out what was really happening, the medical team ordered CT scans of his chest, abdomen, and pelvis. The scans showed tiny nodules in his lungs, a pattern typical of miliary tuberculosis. This form of TB occurs when the bacteria spread widely through the bloodstream and cause small lesions in various organs. The name “miliary” comes from the millet seed-like appearance of these spots.
While TB primarily affects the lungs, it can infect almost any part of the body. However, TB infecting the penis is very rare—less than 1% of urinary or genital tract TB cases. In this man’s case, the combination of lung findings and his immune suppression pointed toward a systemic TB infection.
Laboratory tests confirmed the presence of Mycobacterium tuberculosis in his respiratory tract. Tissue samples from his penis also tested positive for the bacteria, though doctors couldn’t determine the exact species. Treatment involved a 12-month course of four antibiotics tailored to his situation, considering his transplant. The goal was to clear the infection without interfering with his kidney function.
Challenges and Uncertain Origins
His penile lesion worsened before improving. He developed a large, dead tissue ulcer on his penis, and the foreskin started breaking down. Surgeons had to remove the necrotic tissue to help his recovery. After a year of treatment, his condition improved, and the lesion healed.
Doctors are still unsure how he contracted the TB. He didn’t report contact with known TB patients or visits to crowded places like prisons. It’s possible the bacteria had been hiding in his transplanted kidney. Alternatively, his exposure to infected animals might have been the source. Both deer and cattle can carry Mycobacterium bovis, which can infect humans through inhalation or direct contact with infected tissues during slaughtering.
Interestingly, it’s not clear whether his infection started in his lungs or on his penis. He could have inhaled the bacteria first, or he might have spread it through contact. There’s a similar known condition called “Prosector’s wart,” where medical professionals develop skin infections from handling TB-infected tissues.
While the exact route of his infection remains a mystery, the good news is that cases like this respond well to proper TB treatment. The doctors noted that all previously reported cases of penile TB have resulted in full recovery after antibiotics. This case reminds us that TB can sometimes take unexpected forms, especially in immunocompromised individuals.
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