附睾结核是罕见的,通常存在诊断困难。它可能表明感染的传播形式,我们的病人就是这样.一个19岁的男人,没有既往病史,因左侧阴囊肿胀疼痛而入院,该阴囊已经演变了8个月。他接受了睾丸切除术,解剖病理学检查与附睾结核一致。放射学检查揭示了感染的其他定位:淋巴,肺,顶骨和骨关节结核。介绍了抗结核治疗。然而,在治疗的第四个月,患者出现癫痫发作。进行了脑部磁共振成像,最后是脑结核瘤.抗结核治疗继续与抗惊厥药相关,结果良好。我们观察的独创性在于传播的漏状结核病的揭示模式,通过附睾定位,在一个有免疫能力的病人身上。
Epididymal tuberculosis is rare and often presents diagnostic difficulties. It may be indicative of a disseminated form of the infection, which is the
case of our patient. A 19-year-old man, with no past medical history, was admitted for a swollen painful left scrotum that had been evolving for 8 months. He had undergone an orchiectomy and the anatomopathological examination was consistent with epididymal tuberculosis. The radiological investigations had revealed other localizations of the infection: lymphatic, pulmonary, parietal and osteoarticular tuberculosis. Anti-tuberculosis therapy was introduced. However, in the 4th month of treatment, the patient developed seizures. A cerebral magnetic resonance imaging was practiced, concluding to cerebral tuberculomas. Anti-tuberculosis treatment was continued associated to an anticonvulsant with a favourable outcome. The originality of our observation resides in the mode of revelation of a disseminated paucisymptomatic tuberculosis, by an epididymal localization, in an immunocompetent patient.