Abstract:
Introduction: Urogenital tuberculosis (UGTB) is a common manifestation of extrapulmonary TB (EPTB), which affects both men and women in a ratio of 2:1. Similar to other EPTB types, diagnosis of UGTB is quite challenging owing to atypical clinical presentation and paucibacillary nature of specimens. This review is primarily focused on the current updates developed in the diagnosis of male UGTB.Area covered: Smear/culture, imaging, histopathology, and interferon-γ release assays are the main modalities employed for detecting male UGTB cases. Moreover, we described the utility of nucleic acid amplification tests (NAATs), including loop-mediated isothermal amplification, PCR, nested-PCR, and GeneXpert (MTB/RIF) assays. The possibility of using other novel modalities, such as immuno-PCR (I-PCR), aptamer-linked immobilized sorbent assay (ALISA), and identification of circulating cell-free DNA (cfDNA) by NAATs were also discussed.Expert opinion: The current methods used for the diagnosis of male UGTB are not adequate. Therefore, the latest molecular/immunological tools, i.e. Xpert Ultra, Truenat MTBTM, I-PCR, ALISA, and cfDNA detection employed for the diagnosis of other EPTB forms and pulmonary TB may also be exploited for UGTB diagnosis. Reliable and timely diagnosis of male UGTB may initiate an early start of anti-tubercular therapy that would reduce infertility and other complications associated with disease.
摘要:
简介:泌尿生殖道结核(UGTB)是肺外结核(EPTB)的常见表现,以2:1的比例影响男性和女性。类似于其他EPTB类型,UGTB的诊断是相当具有挑战性的由于不典型的临床表现和标本的细菌性质。这篇综述主要集中在男性UGTB诊断方面的最新动态。覆盖区域:涂片/文化,成像,组织病理学,和干扰素-γ释放试验是用于检测男性UGTB病例的主要方式。此外,我们描述了核酸扩增测试(NAAT)的实用性,包括环介导等温扩增,PCR,巢式PCR,和GeneXpert(MTB/RIF)测定。使用其他新模式的可能性,如免疫PCR(I-PCR),适体连接的固定化吸附剂测定(ALISA),并讨论了NAAT对循环无细胞DNA(cfDNA)的鉴定。专家意见:目前用于诊断男性UGTB的方法还不够充分。因此,最新的分子/免疫学工具,即XpertUltra,TruenatMTBTM,I-PCR,ALISA,用于诊断其他EPTB形式和肺结核的cfDNA检测也可用于UGTB诊断。对男性UGTB的可靠和及时的诊断可以启动抗结核治疗的早期开始,这将减少不育和其他与疾病相关的并发症。