Isolated Polyarteritis Nodosa Presenting as Acute Epididymo-Orchitis: A Case Report

Abstract

Polyarteritis Nodosa is a systemic necrotizing vasculitis typically affecting the small and medium sized blood vessels. It typically involves multiple organ systems with a wide variety of clinical presentations. Rarely, it affects only one organ of the body, also known as Isolated Polyarteritis Nodosa. Testicular involvement, although not uncommon with this disease, is rarely the first presenting sign. We present a case of a 62-year-old Caucasian male who presented with three-month history of pain, swelling and redness around the left testicular region. He was diagnosed with acute epididymo-orchitis and started on broad spectrum antibiotics. However, with progressive symptoms, the patient finally underwent left orchiectomy. Histological analysis of the excised testicle revealed features consistent with microscopic polyarteritis nodosa. The patient was subsequently started on high dose steroids resulting in resolution of his symptoms. Thus, clinicians should consider polyarteritis nodosa in cases simulating a clinical picture of acute epididymo-orchitis. doi:10.4021/jmc97w