title: Juvenile allergic urethritis with urethro-ejaculatory reflux presenting as acute intermittent bilateral testicular torsion.
abstract: We report a case of juvenile allergic urethritis secondary to double concentrate orange squash of a famous brand in a 3-year-old boy who developed bilateral urethro-ejaculatory reflux (UER) and severe urethral, perineal and scrotal pain referred to both lower limbs intermittently predominantly during and after micturition-simulating features of bilateral intermittent testicular torsion. Accurate history, urinalysis, ultrasound, colour Doppler and food challenge were helpful in diagnosis. Topical steroids, antihistaminic, analgesic and anti-inflammatory medications together with withdrawal of the allergen produced complete recovery. Allergic urethritis in association with bilateral UER causing secondary seminal vesiculitis and epididymitis is rare. It presented as acute scrotum and responded to innovative treatment. Allergic disease can have a dramatic effect on a child's quality of life. This is the first documented case of allergic urethritis and associated UER presenting as juvenile acute scrotum. Steroids, antihistamines and anti-inflammatory agents together with avoidance of the allergen helped achieve recovery.
authors.affiliation: Department of Paediatric Surgery, Bristol Royal Hospital for Children, Bristol, UK.
authors.forename: Ramnik V
authors.initials: RV
authors.lastname: Patel
authors.affiliation: Department of Paediatric Surgery, Bristol Royal Hospital for Children, Bristol, UK.
authors.forename: Marina
authors.initials: M
authors.lastname: Brimioulle
authors.affiliation: Department of Medical Student, Birmingham Medical School, Birmingham, UK.
authors.forename: Dhaval
authors.initials: D
authors.lastname: Govani
authors.affiliation: Department of Paediatric Radiology, Bristol Royal Hospital for Children, Bristol, UK.
authors.forename: Talaat
authors.initials: T
authors.lastname: Youssef
mesh_terms: D002253:Carbonated Beverages / Q000009:adverse effects*; D002675:Child, Preschool; D004823:Epididymitis / Q000139:chemically induced / Q000175:diagnosis* / Q000178:diet therapy; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000178:diet therapy; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D016896:Treatment Outcome