A case of an asymptomatic hypoechoic testicular mass in the setting of contralateral orchitis.
BACKGROUND
A 28-year-old heterosexual man presented to an emergency department with a 2-day history of left testicular pain and swelling that began after he started having unprotected sex with a new partner. He also had a 1-day history of fever and chills.


METHODS
Physical examination, urinalysis, complete blood count, polymerase chain reaction testing for gonorrhea and chlamydia, serial scrotal ultrasonography with color Doppler imaging, and measurement of serum tumor marker levels.


METHODS
Left orchitis with right testicular mass suspicious for malignancy.


RESULTS
The patient received antibiotic therapy (ceftriaxone and azithromycin), which resulted in resolution of his presenting symptoms. He was discharged from hospital with plans to undergo follow-up evaluation by the urology service. He opted to delay surgical intervention; repeat ultrasonography at 4 weeks revealed signs consistent with treated left-sided orchitis and revealed near-complete resolution of the right-sided lesion. The patient's right-sided mass probably represented subclinical bacterial orchitis, which responded to antibiotic therapy.
Morris
Richard E A
RE
Waldo County General Hospital, Belfast, ME 04915, USA. richard_morris_md98@post.harvard.edu
Guimaraes
Alexander R
AR
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009920:Orchitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D013737:Testis / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000382:microbiology; D014463:Ultrasonography
D000900:Anti-Bacterial Agents