Abstract
IntroductionTesticular infarction as a result of severe epididymo-orchitis is an uncommon urological emergency, with only a handful of reported cases in literature. We report an even rarer case of bilateral epididymo-orchitis complicated with testicular infarction, resulting in bilateral orchidectomy. Presentation of case49 year old gentleman presented with fever, persistent, unresolving pain and scrotal swelling of two weeks duration. Despite close clinical monitoring, timely ultrasounds of the testis and antibiotics there was an inexorable progression to bilateral testicular ischemia. DiscussionThis is only the second reported case of this nature in published literature. Epididymo-orchitis usually responds well to appropriate antibiotic therapy, although progression to testicular infarction is possible. ConclusionClinical presentation of persistent scrotal pain and oedema in cases of epididymo-orchitis should raise strong suspicion of testicular ischemia or infarction. Despite all efforts, progression to bilateral testicular infarction resulting in castration is a possible catastrophic outcome.
Highlights
Testicular infarction as a result of severe epididymo-orchitis is an uncommon urological emergency, with only a handful of reported cases in literature
David Eisner and colleagues were the first to report a case of bilateral testicular infarction secondary to epididymitis [4]
We present this rare case of bilateral testicular infarction caused by severe non-resolving bilateral epididymo-orchitis, which eventually led to anorchia and lifelong testosterone replacement therapy
Summary
Testicular infarction as a result of severe epididymo-orchitis is an uncommon urological emergency, with only a handful of reported cases in literature. We report an even rarer case of bilateral epididymo-orchitis complicated with testicular infarction, resulting in bilateral orchidectomy. PRESENTATION OF CASE: 49 year old gentleman presented with fever, persistent, unresolving pain and scrotal swelling of two weeks duration. Timely ultrasounds of the testis and antibiotics there was an inexorable progression to bilateral testicular ischemia. Epididymoorchitis usually responds well to appropriate antibiotic therapy, progression to testicular infarction is possible. CONCLUSION: Clinical presentation of persistent scrotal pain and oedema in cases of epididymo-orchitis should raise strong suspicion of testicular ischemia or infarction. Progression to bilateral testicular infarction resulting in castration is a possible catastrophic outcome
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