Tuberculous epididymitis masquerading as acute scrotal abscess

Abstract

Isolated tuberculous epididymitis is a rare form of genitourinary tuberculosis. It presents with non-specific symptoms thus warranting a high clinical suspicion and timely diagnosis in order to prevent later complications. We present a case of epididymal tuberculosis which presented as an acute scrotal abscess in a 60 year old male. The case had a painful scrotal swelling that was initially drained as a non-specific abscess. However, a strong index of suspicion along with use of diagnostic modalities like the TB-PCR (Polymerase Chain Reaction) allowed the diagnosis of isolated tuberculous epididymitis. Meticulous debridements along with prompt anti-tuberculous chemotherapy then resulted in a favourable outcome. This report attempts to highlight the rarity of this clinical picture, and the importance of a high index of suspicion in facilitating diagnosis and early treatment.