A rare coexistence: Isolated prostate tuberculosis and nodular prostatic hyperplasia: A case report

INTRODUCTION AND IMPORTANCE: Isolated prostate tuberculosis is exceedingly rare, accounting for only 2.6 % of genitourinary TB cases. This condition often presents with mildly elevated PSA levels and imaging findings that may resemble those of advanced prostate cancer. This case holds significant value due to the rarity of documented reports worldwide and diagnostic challenges. It provides an essential perspective for physicians, encouraging them to maintain a heightened index of suspicion for prostatic tuberculosis in patients presenting with vague lower urinary tract symptoms and features of anemia, particularly in endemic regions. CASE PRESENTATION: Our case is a 75-year-old male patient who presented with non-specific lower urinary tract symptoms and features of anemia. Histopathologic examination confirmed the diagnosis of primary tuberculosis with nodular prostatic hyperplasia. Following anti-Tb treatment he showed notable improvement. CLINICAL DISCUSSION: The spread of infection to the prostate is primarily hematogenous. Prostatic tuberculosis is usually asymptomatic or subclinical in the early stage and nonspecific irritating micturition in the late stage. The mainstay of management for TB prostatitis is medical treatment using multiple anti-TB drug combinations. Surgical therapy can be considered if patients do not respond to medical therapy. CONCLUSION: Isolated prostatic tuberculosis is a rare clinical entity in which it can mimic non-specific prostatitis and prostatic carcinoma by its similar clinical presentation and digital rectal examination finding. Definitive diagnosis must be made by histopathological and bacteriologic studies.