title: Testicular trauma resulting in shock and systemic inflammatory response syndrome: a case report.
abstract: BACKGROUND
  Acute painful scrotum in children may be associated with torsion of the testis, hematocele, epididymitis and direct testicular injury with hematoma formation. More frequently, however, acute scrotum occurs without a precipitating factor. While most traumatic testicular injuries resolve with conservative management, many require surgical exploration and some are life-threatening.
  
  
  METHODS
  A 13-year-old boy with a history of testicular trauma presented with severe scrotal swelling and shock. This case study examines the presentation and possible role of cytokines in the development of systemic inflammatory response syndrome in a child with acute traumatic epididymitis.
  
  
  CONCLUSIONS
  Post-traumatic epididymitis presenting as shock in boys is rarely reported. We advocate early recognition of the chain of events leading to clinical presentation of shock and prompt treatment to preserve testicular viability.
authors.affiliation: University of Kansas, Department of Pediatrics, Kansas City, Kansas, USA. drkingsleyo@yahoo.com
authors.forename: Kingsley C
authors.initials: KC
authors.lastname: Okonkwo
authors.forename: Kristin G
authors.initials: KG
authors.lastname: Wong
authors.forename: Cheng T
authors.initials: CT
authors.lastname: Cho
authors.forename: Lisa
authors.initials: L
authors.lastname: Gilmer