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Infant penile tuberculosis following circumcision

Vassiliki Papaevangelou1, Artemis Vintila, Josef Papaparaskevas

  • 1Second Department of Pediatrics, University of Athens Medical School, P. & A. Kyriakou Children's Hospital, Thivon & Livadias, 11527 Goudi, Greece.

The Journal of Infection
|December 23, 2008
PubMed

Insights

A 10-month-old infant presented with penile tuberculosis and inguinal lymphadenopathy after circumcision abroad. Mycobacterium tuberculosis was confirmed in penile and lymph node samples, highlighting a rare presentation of pediatric urogenital tuberculosis.

Area of Science:

  • Pediatric infectious diseases
  • Urogenital tuberculosis
  • Mycobacterial infections

Background:

  • Primary penile tuberculosis is exceptionally rare, particularly in infants.
  • Urogenital tuberculosis often presents with renal or bladder involvement, not typically penile lesions.
  • Recent travel or circumcision in endemic areas can be risk factors for disseminated tuberculosis.

Observation:

  • A previously healthy 10-month-old infant developed a penile ulcer and bilateral inguinal lymphadenopathy.
  • The infant had undergone circumcision in Pakistan four months prior to presentation.
  • Clinical examination revealed significant swelling and ulceration of the penile shaft and enlarged inguinal lymph nodes.

Findings:

  • Microscopy revealed acid-fast bacilli in penile ulcer exudate and lymph node tissue.
  • Polymerase chain reaction (PCR) confirmed the presence of Mycobacterium tuberculosis DNA in both sample types.
  • Culture of penile and lymph node specimens yielded Mycobacterium tuberculosis, confirming the diagnosis.

Implications:

  • This case underscores the importance of considering tuberculosis in infants presenting with unusual genital lesions, especially with a relevant travel history.
  • Early diagnosis and treatment are crucial to prevent complications and dissemination of the disease.
  • Penile tuberculosis, though rare, should be included in the differential diagnosis of penile ulcers in pediatric populations.

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