Primary tuberculosis of the penis in a renal transplant patient

Background: Extrapulmonary tuberculosis is a complication of pulmonary tuberculosis that is disseminated through hematogenous or lymphatic system and may involve any organs. We present a case of primary tuberculosis of the penis that is a very rare presentation of tuberculosis. Patient: The patient was a 43-year-old man who had kidney transplantation. He admitted with painful ulceration on the glans of penis. Physical examination strongly suggested ulcer lesion that resemble to carcinoma or herpetic ulcer. He did not have any evidence of pulmonary tuberculosis. Having received empiric treatment against herpetic, bacterial and fungal infection, his condition did not improve and he was ordered biopsy of the lesion. Histopathologic studies and PCR revealed Mycobacterium tuberculosis, thus, anti-TB drugs were commenced. The ulcer was improved without any recurrence during a two-year follow up. Conclusion: In patients with kidney transplantation especially in countries endemic for Mycobacterium tuberculosis, chronic ulcer not responding to empiric therapy should be evaluated for Mycobacterium tuberculosis infection.