Case report of bilateral testicular infarction due to severe bilateral epididymo-orchitis: A catastrophic complication causing castration

International Journal of Surgery Case Reports
William Ong Lay KeatPremnath Nagalingam

Abstract

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. 49 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. This 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. Clinical 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.

References

Sep 1, 1991·AJR. American Journal of Roentgenology·D J EisnerS H Millmond
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Apr 7, 2015·Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada·Sasha Rachel FehilyOlga Vujovic
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Feb 10, 2018·Journal of Surgical Case Reports·Adrian RhuddGareth Reid
Oct 21, 2018·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group

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