Abstract

Introduction While genitourinary tuberculosis (GUTB) accounts for up to 30% of extrapulmonary TB, epididymal involve ment accounts for only about 20% of GUTB1,2. Only a paucity of cases regarding epididymo-orchitis and scrotal involvement without renal or pulmonary involvement has been reported until today3–5. Clinical manifestations of this rare situation are variable and may include fever, increased frequency of urination, frank pain, dysuria with sterile pyuria or blood in the urine, suprapubic pain or a painless testicular mass3,6. Isolated tuberculous epididymitis (ITE) can be potentially cured by anti-TB medications if diagnosed correctly, and surgi cal resection is usually reserved for those patients who do not respond to medical treatment7. However, ITE may present with a clinical picture similar to that of a scrotal neoplasm and diagnosis may be challenging for physicians. We report a case of a patient with ITE diagnosed after undergoing a high inguinal orchiectomy for a suspected testicular tumour.

Highlights

  • Isolated tuberculous epididymitis usually presents with a clinical picture and radiographic illustrations similar to those of a scrotal neoplasm; diagnosis can be challenging for physicians

  • Clinicians should be aware of the case of isolated tuberculous epididymitis, an entity that can be potentially cured by anti-TB medications if diagnosed in an incipient phase

  • Isolated tuberculous epididymitis (ITE) can be potentially cured by anti-TB medications if diagnosed correctly, and surgi­cal resection is usually reserved for those patients who do not respond to medical treatment[7]

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Summary

Conclusion

This case illustrates that extrapulmonary appearance of TB often seen in middle-aged men may mimic testicular neoplasm. INH, isoniazid; RMP, rifampicin; EMB, ethambutol; SM, streptomycin; PZA, pyrazinamide of extrapulmonary TB presentation. In this respect, diagnostic work-up in young men with swollen testicle should be thorough in order to avoid an unnecessary orchectomy. Abbreviations list CT, computer tomography; EMB, ethambutol; GUTB, genitourinary tuberculosis; INH, iso­niazid; ITE, isolated tuberculous epididymitis; PZA, pyrazinamide; RMP, rifampicin; SM, streptomycin; TB, tuberculosis. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal

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