Case Report Tuberculous Ulcer of Penis and Effect of Short Course Chemotherapy

Rare case of tuberculous penis showing excellent response to short course chemotherapy is presented in this communication. It is suggested that tuberculer aetiology should be kept in the differential diagnosis of penile ulcer. Key words: Tuberculosis, male genitalia. [Indian J Chest Dis Allied Sci, 37, 2, 1995, pp 89-91] Tuberculosis of penis is extremely rare1. There are isolated reports of its presentation as a subcutaneous nodule with or without superficial ulcers2. We herewith report a case of tuberculous ulcer which showed excellent response to short course chemotherapy. Case Report A 30-year-old Hindu male presented with an ulcer over the prepuce of the penis of 3 weeks duration with history of loss of appetite and weight. There was no history suggestive of tuberculosis, diabetes mellitus or venereal disease. He was married 7 years back and his wife was a known case of pulmonary tuberculosis for which she took antituberculous treatment for 3 months in the past. The patient was treated with penicillin by a local medical practitioner for 2 weeks with no relief. His general physical examination was unremarkable. The local examination revealed that the penile ulcer was 4 cm x 3 cm in size with undermined edges with necrotic base (Fig. 1). His haemoglobin was 9 g/dl and blood counts and blood chemistry were non-contributroy. Chest skiagram was normal. Mantoux test With 1 TU of PPD was 8 x 7 mm. VDRL and ELISA tests for HIV antibody were nonreactive. Excretory urogram was normal. The histopathological examination of ulcer edge showed reactive inflammatory changes. However, smear taken for necrotic material1 was positive for acid fast stain. Treatment was started with short course chemotherapy of 2EHRZ/4HR in standard doses. Complete healing of penile ulcer occurred within one month of anti- tuberculosis therapy. Patient completed 6 months of therapy regularly with no recurrence after one year of follow up