Dell'Atti L
G Chir. 2014 May-Jun;35(5-6):134-6.
We present an unusual case of tuberculous epididymitis in a 33-year-old African patient, who was referred to our Department of Urology with a right intrascrotal mass. There was no evidence of fever, hematuria, dysuria or symptoms from the lower urinary tract. The patient did not demonstrate any laboratory signs of inflammation (white blood cells, C reactive protein). Scrotal sonography revealed a solid heterogeneous, hypoecoic lesion between the epididymal head and the upper testis pole, with disruption of the architecture of the testicular parenchyma. Strong ultrasound suspicion of tuberculous etiology was confirmed by epididymectomy and partial orchiectomy. The patient started an antitubercular treatment. Although rare, epididymal TB may be the only clinically evident location of infection. Clinical suspicion and prompt diagnosis are important because earlier treatment can prevent complications and lead to clinical improvement.
我们报告了一例33岁非洲患者的罕见结核性附睾炎病例,该患者因右侧阴囊内肿物被转诊至我们的泌尿外科。没有发热、血尿、尿痛或下尿路症状的证据。患者未表现出任何炎症的实验室指标(白细胞、C反应蛋白)。阴囊超声显示附睾头部与睾丸上极之间有一个实性、不均匀、低回声病变,睾丸实质结构破坏。附睾切除术和部分睾丸切除术证实了超声对结核病因的高度怀疑。患者开始了抗结核治疗。虽然罕见,但附睾结核可能是感染的唯一临床明显部位。临床怀疑和及时诊断很重要,因为早期治疗可以预防并发症并带来临床改善。