Epididymo-orchitis and testicular abscess caused by Salmonella enteritidis in immunocompromised patients in Kuwait.

OBJECTIVE To report relatively uncommon presentations of epididymo-orchitis and testicular abscess caused by Salmonella spp. in 2 immunocompromised patients. CLINICAL PRESENTATION AND INTERVENTION A 56-year-old man, a known case of systemic lupus erythematosus on azathioprine and prednisolone therapy, developed urinary tract infection followed by bacteremia and epididymo-orchitis. Both urine and blood cultures yielded Salmonella enteritidis strains, which were demonstrated by pulsed-field gel electrophoresis typing method to be genotypically identical. The second patient, a 55-year-old diabetic (type II), presented with a testicular abscess from which a pure culture of S. enteritidis was obtained. Both were treated with intravenous piperacillin and amikacin followed by oral ciprofloxacin, responded well to the therapeutic regimen and were discharged home well. Their follow-ups were uneventful. CONCLUSION This report shows that it is important to consider Salmonella infection in the differential diagnosis of inflamed and tender testis in immunocompromised patients and to include blood, urine and stool cultures in all cases.