A Case of Disseminated Tuberculosis Presenting as Scrotal Swelling
A 28-year-old male patient presented with right-sided scrotal swelling and pain for the past two months. He had a history of loss of appetite and weight, as well as fever for the past ten days. He had no comorbidities. Complete blood count and blood chemistry, including fasting blood glucose, re...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18173/62874_CE[Ra1]_F(IS)_PF1(VH_IS)_PFA(OM)_PN(KM).pdf |
| Summary: | A 28-year-old male patient presented with right-sided scrotal
swelling and pain for the past two months. He had a history of
loss of appetite and weight, as well as fever for the past ten
days. He had no comorbidities. Complete blood count and blood
chemistry, including fasting blood glucose, renal, and liver function
tests, were normal. Scrotal ultrasound revealed an enlarged right
testis and epididymis with heterogeneous echotexture in the right
testis and multiple small hypoechoic lesions within it. There was
also a focal fluid collection with septations in the right scrotal sac,
adjacent to the epididymis [Table/Fig-1]. Increased vascularity
in the testis and epididymis indicated inflammation. These
ultrasound findings suggested right epididymo-orchitis with an
abscess in the extra testicular space of the right scrotal sac,
near the epididymis. Abdominal ultrasound was normal. Chest
X-ray revealed multiple miliary nodules in both lung fields and a
small left-sided pleural effusion, which was confirmed on chest
CT [Table/Fig-2a,b]. Contrast-enhanced magnetic resonance
imaging of the brain showed multiple small enhancing lesions
in the bilateral cerebral and cerebellar hemispheres, as well
as the brainstem, with smooth leptomeningeal enhancement.
These findings were suggestive of multiple tuberculomas with
meningitis [Table/Fig-2c,d]. The patient later underwent drainage
of right scrotal abscess and right epididymo-orchidectomy, as
the epididymis had sloughed off due to infection [Table/Fig-3].
Mycobacterium tuberculosis was detected in the pus sample using
the Mycobacterium tuberculosis DNA test, with no resistance to
rifampicin. The patient responded well to antitubercular therapy
and is currently being followed up. |
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| ISSN: | 2249-782X 0973-709X |