title: Tuberculous epididymo-orchitis presenting within the setting of a sexually transmitted disease clinic.
abstract: BACKGROUND
  Tuberculous epididymo-orchitis (TBEO) is uncommon in Western cities in the modern era. A case series of 3 patients with TBEO presenting to a sexually transmitted diseases (STD) clinic has never previously been reported.
  
  
  OBJECTIVE
  The goal of this study was to report all known cases of TBEO attending a London STD clinic within the last 6 years.
  
  
  METHODS
  We conducted a case analyses.
  
  
  RESULTS
  The 3 patients aged 30, 42, and 47 years were all HIV-negative and immigrants (2 black Africans, 1 Middle Eastern). The median duration of scrotal swelling was 3 months (range, 2-4 months). Mycobacterium tuberculosis was isolated from early-morning urine specimens in 2 of 3 cases. All had grade IV Heaf test (equivalent to greater than 15 mm Mantoux induration), unilateral TBEO without renal tract disease, and responded to antituberculous chemotherapy.
  
  
  CONCLUSIONS
  The changing epidemiology of TB and demography of Western countries could lead to an increase in such patients presenting at STD clinics. The early diagnosis of TBEO, which is aided by clinical acumen and conventional diagnostic tools, can prevent complications.
authors.affiliation: The Patrick Clements Clinic, Central Middlesex Hospital, North West London Hospitals NHS Trust, London, United Kingdom. fchenff@msn.com
authors.forename: Fabian
authors.initials: F
authors.lastname: Chen
authors.forename: Gary
authors.initials: G
authors.lastname: Brook
authors.forename: Gillian
authors.initials: G
authors.lastname: Williams
authors.forename: Siobhan
authors.initials: S
authors.lastname: Murphy
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004823:Epididymitis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000382:microbiology*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D014389:Tuberculosis, Male Genital / Q000175:diagnosis