A rare case of isolated tuberculous epididymitis in a young man presenting with a swollen testicle

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.