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Brucella orchitis: a rare cause of testicular enlargement.

The differential diagnosis of the acutely enlarged testis includes numerous benign and malignant disease processes. Most are treated with radical orchiectomy due to difficulty in differentiating between these disorders preoperatively. Saving the involved testis, prevention of recurrent infectious disease in the opposite testis and prevention of systemic manifestations of testicular disease are but a few of the reasons for accurate diagnosis of the acute scrotum. We report a rare case of brucellosis presenting as an acute scrotal mass and stress the importance of accurately identifying the specific etiology of testicular pathology to prevent long-term morbidity.

Acute Disease↗

Nocardia epididymo-orchitis in an immunosuppressed patient.

The immunocompromised patient after organ transplantation is susceptible to unusual and life-threatening infections. We report a case of epididymitis that evolved into testicular nocardiosis after cardiac transplantation. An awareness of the potential for these infections and early diagnosis may prevent extensive morbidity in the post-transplantation patient.

Adult↗

Granulomatous orchitis.

Three cases of an uncommon but extremely interesting inflammatory process are reported. As our discussion indicates, many questions remain unanswered. It is important to recognize this condition because it is often initially thought to be neoplastic. The disease is characterized by acute recurring exacerbations over a long period and is often associated with urinary tract infections or trauma. The testis is almost always extremely firm and frequently enlarged and tender. We believe that orchiectomy is indicated in most instances, except in extremely young individuals and those in whom the only remaining testicle is involved. Biopsy is probably sufficient in the latter case unless symptoms persist. The final diagnosis must rest on the exclusion of other granulomatous diseases as well as the microscopic picture.

Adult↗