title: Testicular loss following bacterial epididymo-orchitis: Case report and literature review.
abstract: Epididymo-orchitis rarely leads to abscess formation and global testicular infarction/loss, particularly in the setting of appropriate antibiotic therapy. The imaging modality used when monitoring for testicular ischemia is ultrasonography. However, as described in the literature, testicular pathology may not be evident on routine imaging. We describe two cases of recurrent bacterial epididymo-orchitis, complicated by testicular abscess resulting in testicular infarction. This rare, nevertheless significant, complication occurred in both patients despite receiving appropriate extended antibiotic therapy. Both cases demonstrate the limitations of ultrasonography alone, suggesting that a high level of clinical suspicion must be maintained when ultrasound evaluation proves to be inconsistent with the clinical presentation. These cases demonstrate the importance of monitoring for warning signs of ischemia, as early recognition may lead to reperfusion interventions and ultimately testicular salvage.
authors.affiliation: Department of Infectious Diseases, Alfred Health, Melbourne VIC, Australia;
authors.forename: Sasha Rachel
authors.initials: SR
authors.lastname: Fehily
authors.affiliation: Department of Infectious Diseases, Alfred Health, Melbourne VIC, Australia;
authors.forename: Jason Anthony
authors.initials: JA
authors.lastname: Trubiano
authors.affiliation: Department of Anatomical Pathology, Alfred Health, Melbourne VIC, Australia;
authors.forename: Catriona
authors.initials: C
authors.lastname: McLean
authors.affiliation: Department of Surgery, Alfred Health, Melbourne VIC, Australia;
authors.forename: Boon Wei
authors.initials: BW
authors.lastname: Teoh
authors.affiliation: Department of Surgery, Alfred Health, Melbourne VIC, Australia;
authors.forename: Jeremy Peter
authors.initials: JP
authors.lastname: Grummet
authors.affiliation: Department of Infectious Diseases, Alfred Health, Melbourne VIC, Australia; ; Monash University, Clayton VIC; and the Centre for Biomedical Research, Burnet Institute, Melbourne VIC; and the University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Catherine Louise
authors.initials: CL
authors.lastname: Cherry
authors.affiliation: Department of Infectious Diseases, Alfred Health, Melbourne VIC, Australia;
authors.forename: Olga
authors.initials: O
authors.lastname: Vujovic
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