All pain, no gain: When epididymitis drops the ball.

Testicular infarction due to acute epididymitis is a rare but serious complication caused by inflammation that impairs blood flow to the testis. Epididymitis, frequently associated with bacterial infections, usually presents with scrotal pain and swelling, and is commonly managed with a brief course of antibiotics. However, in severe cases, it can progress to ischemia and infarction. This report describes a 46-year-old male with type 2 diabetes who presented with a 1-week history of left testicular pain and swelling. An initial ultrasound confirmed epididymitis, but despite intravenous antibiotic treatment, his symptoms worsened by the second day. Repeat imaging revealed the absence of blood flow, consistent with testicular infarction. This case underscores the importance of timely diagnosis and intervention to prevent such complications.