Prostatic tuberculosis incidentally discovered during transurethral resection of prostate with subsequent diagnosis of rectal and pulmonary involvement: a case report

BACKGROUND: Tuberculosis (TB) is a globally prevalent infectious disease, including in Taiwan. Prostatic TB is a rare manifestation of genitourinary tuberculosis (GU-TB), which is the third most common extrapulmonary form of the disease. However, due to its insidious onset and non-specific symptoms, prostatic TB is often diagnosed late. CASE DESCRIPTION: We report a case of a 72-year-old male patient who presented with lower urinary tract symptoms (LUTS) and painful scrotal swelling. Following transurethral resection of the prostate (TURP), histopathological examination revealed prostatic TB. The patient subsequently had abdominal cramping and diarrhea. A colonoscopy detected an ulcer-like lesion in the rectum, indicating mycobacterial infection and cytomegalovirus colitis. Chest computed tomography revealed pulmonary involvement, and the patient was started on a six-month course of anti-TB treatment. CONCLUSIONS: This case highlights the importance of considering TB in the differential diagnosis of LUTS and highlights the need for screening for other potential sites of involvement, particularly in the lungs, when a diagnosis of prostatic TB is made.