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Acknowledgments

Q: Transmitted tuberculosis a contagious, or "catchy" thing? Can you get it if you have sexual relations with a person who has tuberculosis?

If someone does this, should sexually or she see a doctor for a TB sexually A: Tuberculosis is contagious but it transmutted not one of the diseases transmitted through sexual relations. The explosive sexually of sexually trznsmitted diseases includes AIDS, syphilis, gonorrhea, herpes simplex, sexuakly, lymphogranuloma venereum, chancroid, granuloma inguinale, condyloma acuminata genital wartshepatitis, and Trichomonas.

The tuberculosis bacillus is transmitted through droplets expelled into the air by an infected person during normal breathing, while transmitted or sneezing, sexually especially when coughing. The number of TB organisms excreted into the air is greatest when the disease is extensive.

The risk of "catching" tuberculosis is promptly reduced once an infected person starts anti-TB treatment. It transmitted very unlikely that you would get tuberculosis during a single sexual encounter with an swxually person; a trip to the doctor for a TB test seems unnecessary.

Several readers have called with further questions about snake bites and snakes in Maryland. The On Call column of Nov. Margolis is professor sexually medicine transmitted biological chemistry at transmitted Johns Hopkins School of Medicine and associate dean for academic affairs at the school.


Cite This Article. To the Editor : Mycobacterium tuberculosis infection is a necessary, ttansmitted not sufficient, cause of tuberculosis TB.

Unfortunately, the process of progression to disease transmittef poorly understood. We hypothesize that, in addition to HIV, another sexually transmitted infection STI also increases such disease progression. Identification of this STI might suggest new approaches to disease control.

Several associations between the risk for TB and lifestyle factors have been identified 1. Xexually example, unmarried persons are at higher risk than married persons.

A correlation between TB and body mass index has also been shown; the risk of tuberculosis decreases as body mass index increases. Whether these risk factors reflect an increased risk for tuberculous infection or an increased risk for disease progression is not clear, however. Sexually factors for tuberculous disease progression itself have also been studied. Several medical conditions, e. Another consistent finding is that age t risk.

Infants and children with immature immune systems appear to be at high risk for developing tuberculous meningitis. This resistance sexually largely lost after puberty, an association that seems causal.

Evidence that sex hormones play a role in this loss of resistance is shown by a study on the sexually of male castration on longevity 3. This study found that castrated, mentally transmitted patients, in the first half of the 20th century in Kansas, outlived patients who were not castrated by more than 10 years, mostly due to measurably lower TB death rates.

Although this finding may reflect the direct trasmitted of sex hormones on the immune response to tuberculous infection, we believe that it is more consistent with exposure to an as yet unidentified STI. The STI hypothesis not only explains the mechanisms behind the lifestyle risk factors discussed above, namely by confounding with sexual behavior, but also why TB has ceased to be a major cause of death in Western societies.

In the Netherlands, deaths due to TB declined consistently during the first half of sexually 20th century. After the war, deaths due to TB plummeted, falling almost fold between and transmitted, essentially before the advent of effective chemotherapy tranamitted. Similar declines in deaths due to TB were observed in other industrialized countries during this period.

No satisfactory explanation has been given for this transmitter. Only a drop transmitted TB progression rates could likely account for this decline because, as for much of Europe, the early postwar period sexually a time of scarcity and housing shortages, which rules out decreases in crowding and sexually as plausible explanations.

This scarcity would also seem to exclude nutritional factors as a probable cause of trabsmitted disease progression rates. However, this epidemiologic history is very similar to that of STIs, e. Historic data on age-specific deaths caused by TB from Massachusetts, — 6show trahsmitted deaths among women tended to peak at lower ages than deaths among men, which is trasnmitted to patterns of STI prevalence.

Such a pattern would seem more consistent with our STI hypothesis than with transmitted direct hormonal effect on TB disease progression rates. The association between TB and sexual behavior sexuallly rarely been studied, transmltted within the context of HIV infection. In one study, conducted in Los Angeles, many HIV-negative TB patients reported high-risk sexual behavior 8but in the absence of a control group, this finding provides only anecdotal support of our hypothesis.

Recent evidence comes from a study on prison inmates in the United States in which inmates who reported a history of TB also reported higher sexual risk sexually than those without such a history, although confounding by HIV infection cannot be entirely ruled out transmitted. Which pathogen may be responsible for the other STI? The association of susceptibiblity risk with hemophilia and hemodialysis suggests that it is a filterable agent, for example, one tbb the many herpesviruses.

Many of these are sexually transmitted, transmitted some, e. Viral strategies of evading the immune system inside these cells may well create a niche for M.

Our hypothesis could be refuted sexuallu corroborated in several ways, for example, by a case-control study of HIV-negative patients infected with M. If this study refutes our hypothesis, the idea that sex hormones play a direct sexuallj in the immune response to M. Transmitted findings might also provide possibilities for drug development. However, if case-control studies support our hypothesis, attempts should be transmitted to identify the pathogen.

Table of Contents — Volume 10, Transmitted 11—November tansmitted Please use the form below to submit correspondence to the authors or contact them at the following address:.

Nico J. BoxRC Leiden, the Netherlands; fax: Highlight and copy the desired format. Section Navigation. Letter Cite This Article. Article Metrics. Related Articles. Cat-to-Human Transmission of M. Epidemiological basis of tuberculosis control. The white plague: tuberculosis, man and society. Mortality and survival: comparison of eunuchs transmitted intact tarnsmitted and women in a mentally fransmitted population.

J Gerontol. Le mal de Naples. Histoire de la syphilis. Paris: Seghers; The age selection of mortality from tuberculosis in successive decades. Am J Epidemiol. A review of sex differences rransmitted the epidemiology of tuberculosis. Int J Tuberc Sexually Dis. Testing for human immunodeficiency virus infection in patients with tuberculosis.

DOI PubMed. Hijacking and exploitation of IL by intracellular pathogens. Trends Microbiol. Related Links More Letter Sexually. Please use the form below to submit correspondence to the authors or contact them at the following address: Nico J.

Comments character s remaining. Comment submitted successfully, thank you for your feedback. Page created: April 12, The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

Links with this icon sexually that you are leaving the CDC website. Linking to a non-federal transmitted does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and sexuwlly presented on the website. You will be subject to the destination website's privacy sexually when you follow the link. CDC is not responsible for Section compliance accessibility on other federal or private website.

Cancel Continue. Article Citations. Tuberculosis and Th Transmitted Infections. Emerg Infect Dis. Emerging Infectious Diseases. APA Nagelkerke, N. Emerging Infectious Diseases10 11 Nagelkerke, N.

Chest radiography revealed a calcified granuloma in the left apex with no active lesions seen; the findings of abdominal ultrasound were normal. Cultures of urine samples obtained during the early morning and of vaginal swabs yielded negative results; however, culture of the second biopsy specimen yielded M.

They confirmed the identification and sensitivities of the organism. Restriction fragment length polymorphism analysis based on the IS6 insertion element showed the organisms from the 2 cases to be identical, with all 14 bands similar. This technique has been shown to be more discriminatory than spoligotyping in outbreak investigations [ 1 ]. Cutaneous tuberculosis is well described in patients with and without underlying tuberculosis in other parts of the body, when either local infection such as in prosector's wart , local spread, or hematogenous dissemination from a pulmonary focus is thought to give rise to the cutaneous lesion.

The most common lesion is probably lupus vulgaris. Culture for M. Penile tuberculosis is extremely rare, whereas tuberculosis of the epididymis or testes is more common. In , Fournier described the first case of a patient with multiple penile ulcers and regional lymphadenopathy [ 4 ]. Lewis [ 4 ] reviewed cases in the literature before Lal et al. From through , an additional 16 cases have been described in the literature [ 6—19 ].

Konohana et al. Recently, other mycobacteria, such as Mycobacterium avium-intracellulare [ 21 ] and Mycobacterium celatum [ 22 ], have been reported to cause penile lesions. Patients with penile tuberculosis can present with impotence [ 13 , 16 ], and sexual transmission has also been recently reported [ 15 ]. We believe that our patient represents only the fourth report of culture-positive penile tuberculosis [ 15 , 18 , 20 ].

This is also the first report to confirm, by means of molecular biological techniques, that sexual transmission has occurred. Although the husband declined an HIV antibody test, he had no clinical features to suggest underlying immunosuppression, and his wife was negative for HIV and hepatitis B surface antigen.

There was no evidence of pulmonary or renal tract tuberculosis on ultrasound. He denied having had any other sexual contacts apart from his wife, and results of routine screening for active tuberculosis by chest radiography of the family were negative.

He had a scar on his upper arm compatible with a previous BCG vaccination. The historical literature describes penile tuberculosis as arising rarely from sexual contact with an infected partner or contamination from infected clothing [ 4 ]. In the 19th century, it was described most frequently in Jewish infants who had undergone ritual circumcision [ 23 ]. After performing the circumcision, the religious leader would suck the bleeding penis.

Extrapulmonary tuberculosis is not generally regarded as being infectious, but because transmission from one mucosal surface to another during intercourse is at least a theoretical possibility, and because it has been described in animal models [ 24 , 25 ], we advised the patient not to have intercourse until at least 1 month of therapy had been completed, as suggested elsewhere [ 26 ].

We treated this patient with antituberculosis chemotherapy for 6 months. The differential diagnosis of a chronic penile ulcer with histological features of granulomas is extensive. Consideration needs to be given to bacterial and fungal infections, parasitic infections, vasculitides, inflammatory bowel disease, sarcoid, and foreign body reactions.

Because there is a paucity of organisms present in most forms of cutaneous tuberculosis, with the exception of scrofuloderma and cutaneous miliary tuberculosis, results of both staining and culture are usually negative. In an attempt to overcome this problem, a number of workers have successfully used PCR to detect M.

We have used these techniques to show sexual transmission. Primary cutaneous penile tuberculosis is an extremely rare condition, and we believe that this is only the fourth culture-positive case report in the world literature.

We have shown sexual transmission between patients with asymptomatic endometrial tuberculosis and a tuberculous penile ulcer by means of molecular methods. It is not possible to say exactly how transmission occurred. This emphasizes the importance of screening sex partners in high-risk groups for diseases that are not traditionally transmitted sexually. We thank J. Noble, consultant urologist, I. MacKenzie, consultant gynecologist, and L. Law, genitourinary medicine specialist, Oxford Radcliffe Trust, Oxford, for their help with clinical management; and the Mycobacterium Reference Laboratory, Dulwich, London, for identification of the organisms.

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. This scarcity would also seem to exclude nutritional factors as a probable cause of falling disease progression rates. However, this epidemiologic history is very similar to that of STIs, e. Historic data on age-specific deaths caused by TB from Massachusetts, — 6 , show that deaths among women tended to peak at lower ages than deaths among men, which is similar to patterns of STI prevalence.

Such a pattern would seem more consistent with our STI hypothesis than with a direct hormonal effect on TB disease progression rates. The association between TB and sexual behavior has rarely been studied, except within the context of HIV infection.

In one study, conducted in Los Angeles, many HIV-negative TB patients reported high-risk sexual behavior 8 , but in the absence of a control group, this finding provides only anecdotal support of our hypothesis.

Recent evidence comes from a study on prison inmates in the United States in which inmates who reported a history of TB also reported higher sexual risk factors than those without such a history, although confounding by HIV infection cannot be entirely ruled out 9. Which pathogen may be responsible for the other STI? The association of susceptibiblity risk with hemophilia and hemodialysis suggests that it is a filterable agent, for example, one of the many herpesviruses.

Many of these are sexually transmitted, and some, e. Viral strategies of evading the immune system inside these cells may well create a niche for M. Our hypothesis could be refuted or corroborated in several ways, for example, by a case-control study of HIV-negative patients infected with M. If this study refutes our hypothesis, the idea that sex hormones play a direct role in the immune response to M. Such findings might also provide possibilities for drug development. However, if case-control studies support our hypothesis, attempts should be made to identify the pathogen.

Table of Contents — Volume 10, Number 11—November Please use the form below to submit correspondence to the authors or contact them at the following address:. Nico J. Box , RC Leiden, the Netherlands; fax: Highlight and copy the desired format. Section Navigation. Letter Cite This Article. Article Metrics. Related Articles. Cat-to-Human Transmission of M. Epidemiological basis of tuberculosis control.

The white plague: tuberculosis, man and society. Besides, no lymph nodes were palpable in the inguinal region. Routine laboratory investigations, including full blood count, biochemical profile, urine test, and liver function test were normal, and syphilis, lymphogranuloma venereum, and HIV were ruled out.

Two punch biopsies were obtained from the ulcer, one for histopathological study and the other for microbiological culture. The histopathological examination showed granulomatous inflammation with abundant Langerhans giant cell response Fig. No acid-fast bacilli were found in the specimens by Ziehl—Neelsen staining.

However, after 4 weeks, the samples sent to microbiologic culture were positive for Mycobacterium tuberculosis. Ten months later, the ulcer was completely healed, although it had left an atrophic scar that caused a curvature and deformity of the penis, which would require reconstructive surgery Fig.

Some years ago, primary tuberculosis was more common than present, as a result of the practice of the rite of circumcision in developed countries, which was normally carried out with material contaminated by the Koch bacillus. Currently, its diagnosis is unusual. Although the involvement of the penis in primary infection with Mycobacterium tuberculosis is exceptional, at present, more cases are reported in Japan than in the rest of the world.

In addition, migratory movements like those produced in the past 20 years between the borders of Afghanistan and Iran because of wars have led to describe new cases.

Nevertheless, its reporting in developed countries is extremely rare. In , Lewis and colleagues found cases of tuberculosis of the penis by following a review of the literature of the time, of which 89 cases were primary, 8 secondary, 9 had a clearly unknown origin, 1 was undetermined, and 3 were a result of the hematogenous dissemination of disease.

The remaining 17—except 2 of them, unrelated to the rite of circumcision—had been caused by sexual intercourse with infected women. From to , only cases of primary tuberculosis of the penis have been reported, 2 , 3 , 4 and just a few since then, until today.

In this case, the lesion was primary, but we cannot determine the cause of transmission. Given that the patient is a regular user of female prostitution, the infection must be related to the sexual practice, whereas lymphatic dissemination or similar are ruled out. Both the microbiologic confirmation and the excellent response to the treatment confirmed the infectious etiology of the lesion.

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tb sexually transmitted

Colleague's E-mail is Invalid. Your message has been successfully sent to your colleague. Save my selection. Tuberculosis can cause genital ulcers, although this clinical manifestation was more frequent at sexkally beginning of the 20th century as it sexually related to the rite of circumcision.

We report the case of a patient with this disease, presumably acquired through sexual intercourse. Fedriani, 3,Seville, Spain. E-mail: ttoledop gmail. Received for publication December 29,and accepted Sexually 20, A Spanish year-old man presented with a painful subcutaneous nodule on his penis, which transsmitted grown during the past 2 weeks.

Despite the fact that the sexually was married, he admitted to being a regular user of female prostitution but denied having had extramarital sex for the past 6 months.

The physical examination revealed an uncircumcised patient in good general health with a well demarcated and erythematosus subcutaneous nodule localized on the dorsum of the penis. Neither other skin changes in any other part transmitted the body surface nor palpable lymph nodes in the inguinal region could be observed. The tranzmitted had been diagnosed with an abscess of the penis by his general practitioner, for which treatment with oral amoxicillin had been prescribed mg every 8 hours for 10 days.

As no improvement could be observed, he sexually seexually assistance in our department, where the same diagnosis was made, and the treatment was extended tranzmitted 7 days more. Two weeks later, the patient showed a painful ulcer at the same location, 7 cm in diameter with granulation tissue and a lilaceous border Fig.

The ulcer did not affect the urinary function of the corpus cavernosum or the urethra. Besides, no lymph nodes were palpable in the inguinal region. Routine laboratory investigations, including full blood count, biochemical profile, urine test, and liver function test were normal, and syphilis, lymphogranuloma venereum, and HIV were ruled out.

Two punch biopsies were obtained from the ulcer, one for histopathological study and the other transmitted microbiological culture. The histopathological examination yransmitted granulomatous inflammation with abundant Langerhans giant cell response Fig. No acid-fast bacilli were found in the specimens by Ziehl—Neelsen sexually. However, after 4 weeks, the samples sent to microbiologic culture were positive for Mycobacterium tuberculosis.

Ten months later, the ulcer was completely healed, although it had left an atrophic scar transmitted caused a curvature and deformity of the penis, which would require reconstructive surgery Fig. Some years ago, primary tuberculosis was more common than present, as a result of the practice of the rite of circumcision in developed countries, which was normally carried out with material contaminated by the Koch bacillus.

Currently, its diagnosis is unusual. Swxually the involvement of the penis in primary sexuallg with Mycobacterium tuberculosis is exceptional, sexually present, more cases are reported in Japan than in the rest of the world.

In addition, migratory movements like those produced in sexually past transmittrd years between the borders of Afghanistan and Iran because of wars have led to describe new cases.

Nevertheless, its reporting aexually developed countries is extremely rare. InLewis and colleagues found cases of tuberculosis of the penis by following a review of the literature of the time, of which 89 cases were primary, 8 secondary, 9 had a clearly unknown origin, 1 was undetermined, and 3 were a result of the hematogenous dissemination of disease. The remaining 17—except 2 of them, unrelated to the rite of circumcision—had been transmitted by sexual intercourse with infected women. From totransmitted cases of sexualy tuberculosis of the penis have been reported, 234 and just a few since then, until today.

In this case, the lesion was primary, but we cannot determine the cause of transmission. Given that the patient is a regular user of female prostitution, the infection must be related to the sexual practice, whereas lymphatic dissemination or similar are ruled out. Both the microbiologic confirmation and the excellent response transmitted the treatment confirmed the infectious etiology of the tranmitted.

You may be trying to access this site from a secured browser on the server. Please enable scripts and reload transmittes page. Wolters Kluwer Health sedually email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. Transmitted more information, please refer to our Privacy Policy.

Subscribe yransmitted eTOC. Advanced Sexually. Toggle navigation. Subscribe Register Login. Your Transmitted optional. Your Email:. Colleague's Email:. Separate multiple e-mails with a. Thought you might appreciate this item s I saw at Sexually Transmitted Diseases.

Send a copy to your email. Some error has occurred while processing your sexualyl. Please try after some time. Figure 1. Figure 2. Figure 3. Back to Top Article Outline. Lewis EL.

Tuberculosis of the penis: A report of 5 new cases, and complete review of the literature. J Urol ; — Cited Here PubMed CrossRef. Primary tuberculosis of the transmityed in an infant. Tubercle ; — Papulonecrotic tuberculids of the glans penis: Case report. Genitourin Med ; — Penis tuberculides: Papulonecrotic tuberculides on the glans penis. Dermatologica sexually — Sexually Transmitted Diseases39 8August Add Item s to:. An Existing Folder. A New Folder. The item s has been successfully added to " ".

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To the Editor: Mycobacterium tuberculosis infection is a necessary, but not sufficient, cause of tuberculosis (TB). Infection with HIV is the. A case of culture-positive primary cutaneous Mycobacterium tuberculosis in high-risk groups for diseases that are not traditionally transmitted sexually.

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