Tuberculous epididymo-orchitis masquerading as acute scrotum

Kinnear, Ned; Hoh, Ivan; Campillo, Pedro José Antolinos; Bolt, John

doi:10.1136/bcr-2015-214060

Cited by 11 publications

(11 citation statements)

References 2 publications

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“…He suffered ongoing symptoms and re-presented 6 weeks later with a discharging abscess, which required surgical drainage. Nucleic acid amplification, in addition to AFB microscopy and culture of the surgical specimen, revealed fully-sensitive TB infection, and he responded well to 9 months of anti-tuberculous treatment 2. If his ongoing symptoms had led to suspicion of TB earlier, the discharging abscess formation and subsequent surgical drainage might have been avoided.…”

Section: Discussionmentioning

confidence: 99%

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Atypical testicular pain

et al. 2019

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Testicular tuberculosis (TB) is rare, and, because of this, the lack of pathognomonic clinical features and its tendency to mimic other commoner conditions, the diagnosis is frequently delayed or may be missed. In this case, the initial clinical presentation was typical for bacterial epididymo-orchitis in a 38-year-old man. When the patient failed to improve with standard treatment including broadening of antibiotics, the diagnosis was re-considered because some unusual signs suggested testicular malignancy or lymphoma. Further, history-taking and subsequent cross-sectional imaging with CT/MRI identified co-existent pulmonary nodularity, thoracic and abdominal lymphadenopathy and bony changes that, together, raised the suspicion of TB. Mycobacterium tuberculosis was confirmed on DNA-based testing of the hydrocele fluid, although standard acid-fast bacilli culture was negative. This case prompted a review of the literature to explore the optimal steps in the investigation and diagnosis of this rare disease.

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Section: Discussionmentioning

confidence: 99%

“…Tuberculosis (TB) is well known to mimic other pathology, which can lead to delayed or missed diagnosis 1–5. TB remains a major global health problem.…”

Section: Introductionmentioning

confidence: 99%

Atypical testicular pain

et al. 2019

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“…Many times, an atypical presentation can cause either delayed diagnosis or misdiagnosis and can lead to inadvertent orchiectomy, as it mimics testicular tumors. Kinnear et al reported a case where the patient with a similar presentation initially diagnosed with bacterial epididymoorchitis and treated with antibiotics first [9]. Later, the patient represented with a testicular abscess formation, which was confirmed with incision and drainage, and the patient was then started on anti-tuberculous therapy.…”

Section: Discussionmentioning

confidence: 99%

“…He never developed any ulcer, fistula, or clinically appreciable abscess on daily physical examination. In the literature, multiple similar and atypical presentations of EPTB have been reported after being misdiagnosed or delayed diagnosis with the patient eventually getting inadvertent orchiectomy for similar reasons [9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

A Review of the Diagnostic Use of Fine-needle Aspiration Cytology for Tuberculosis Epididymo-orchitis: To Do or Not to Do

Sharma¹,

Nagalli²,

Varughese³

et al. 2020

Cureus

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Isolated tuberculous epididymo-orchitis is a rare manifestation of the vast extrapulmonary tuberculosis (EPTB) disease spectrum, especially in developed nations, making it prone to delayed diagnosis or misdiagnosis and inadvertent orchiectomy. Several observational studies and case reports have been reported with the successful use of fine-needle aspiration cytology (FNAC) in diagnosing tuberculosis orchitis, thus avoiding inadvertent orchiectomy. Because tuberculous epididymo-orchitis can mimic testicular neoplasm, the use of FNAC is not prevalent in developed countries for fear of the seeding of tumor cells and there is a lack of consensus on the use of FNAC for diagnostic purposes in such patients. We report a case of a 27-year-old man with an atypical presentation of genitourinary tuberculosis (TB) and its management. The case report also reviews the literature to discuss the available evidence and tries to answer the long-standing question on the role of FNAC in the diagnosis of tuberculous epididymo-orchitis.The currently available literature has demonstrated the safety and efficacy of FNAC in diagnosing TB epididymo-orchitis and, based on our review, the benefits of differentiating TB epididymo-orchitis from testicular malignancy using FNAC exceeds its minimal risk and must be considered to minimize clinical diagnosis error and unnecessary orchiectomy in low-risk patients.

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“…Extra-pulmonary TB occurs in approximately 10% of the total cases of TB [Frigueiredo & Lucon, 2008;Lamichaney et al 2014], with most common presentations being lymphatics, pleura, bone/joint, and genitourinary (GUTB). GUTB frequently involves the kidneys and prostate, making the scrotal organs an unusual but possible target site [Figuereido & Lucon, 2008;Kinnear et al 2016]. We present a case report of a healthy young man with a longstanding left scrotal mass diagnosed as unilateral testicular TB.…”

Section: Introductionmentioning

confidence: 99%

A case of testicular tuberculosis mimicking malignancy in a healthy young man

Abraham

Anariba

Dua

et al. 2016

Therapeutic Advances in Infection

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Genitourinary tuberculosis represents a form of extra-pulmonary tuberculosis that occurs in the kidneys, ureters, seminal vesicles, prostate, testis, vas deferens, and epididymis. Isolated testicular involvement is unusual, and differential diagnosis includes testicular tumor, acute infection, infarction, and granulomatous infection. We report a case of a 36-year-old Ecuadorian man residing in New York, New York, who presented with a painful scrotal mass, weight loss, and purulent discharge from ulcerated lesion in scrotal area 10 years following his immigration to the United States. No other systemic symptoms were noted. Positive QuantiFERON-TB Gold and radio imaging results led to the diagnosis. After extensive workup, acid fast bacilli positive cultures obtained by computed tomography guided fine needle aspiration grew Mycobacterium tuberculosis complex. Anti-tuberculosis chemotherapy was initiated after sensitivity tests were confirmed. Significant recovery after 3 months of directly observed therapy was accomplished.

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Tuberculous epididymo-orchitis masquerading as acute scrotum

Cited by 11 publications

References 2 publications

Atypical testicular pain

Atypical testicular pain

A Review of the Diagnostic Use of Fine-needle Aspiration Cytology for Tuberculosis Epididymo-orchitis: To Do or Not to Do

A case of testicular tuberculosis mimicking malignancy in a healthy young man

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