Unilateral epididymal tuberculosis with scrotal fistula: a case report

Abstract

Tuberculosis (TB) affects millions of people globally every year. Although TB is predominantly a lung infection, it can affect almost any organ system in the body. Therefore, the presentation can be highly variable. Extrapulmonary TB accounts for up to 25% of all reported TB cases, and lymphoreticular and genitourinary systems are the most frequently affected. However, male genital TB infection is a rare phenomenon. A clear majority of patients with male genital TB have a concurrent pulmonary infection. We report a male patient presenting with features suggestive of usual epididymo-orchitis who later developed a frank abscess perforation through a scrotal fistula despite repeated antibiotic courses. He was later diagnosed to have epididymal TB without lung involvement. Clinicians need to be vigilant of tuberculous infection when the accepted treatment of bacterial infections invokes poor responses, especially in areas with TB endemicity.