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Further, history-taking and subsequent cross-sectional imaging with CT\/MRI identified co-existent pulmonary nodularity, thoracic and abdominal lymphadenopathy and bony changes that, together, raised the suspicion of TB. <jats:italic>Mycobacterium tuberculosis<\/jats:italic> was confirmed on DNA-based testing of the hydrocele fluid, although standard acid-fast bacilli culture was negative. This case prompted a review of the literature to explore the optimal steps in the investigation and diagnosis of this rare disease.<\/jats:p>","DOI":"10.1136\/bcr-2018-226697","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T05:13:33Z","timestamp":1550639613000},"page":"e226697","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Atypical testicular pain"],"prefix":"10.1136","volume":"12","author":[{"given":"Nishant","family":"Bedi","sequence":"first","affiliation":[{"name":"Urological Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Naim Che","family":"Rahimi","sequence":"additional","affiliation":[{"name":"Urological Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Menzies","sequence":"additional","affiliation":[{"name":"Respiratory medicine, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jas","family":"Kalsi","sequence":"additional","affiliation":[{"name":"Urological Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,19]]},"reference":[{"key":"2025082801205348000_12.2.e226697.1","doi-asserted-by":"publisher","DOI":"10.1177\/2049936116655261"},{"key":"2025082801205348000_12.2.e226697.2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-214060"},{"key":"2025082801205348000_12.2.e226697.3","doi-asserted-by":"crossref","first-page":"714","DOI":"10.4269\/ajtmh.2007.77.714","article-title":"Scrotal tuberculosis in adult patients: a 10-year clinical experience","volume":"77","author":"Lee","year":"2007","journal-title":"Am J Trop Med Hyg"},{"key":"2025082801205348000_12.2.e226697.4","first-page":"176","article-title":"An unusual presentation of primary male genital tuberculosis","volume":"13","author":"Lakmichi","year":"2011","journal-title":"Rev Urol"},{"key":"2025082801205348000_12.2.e226697.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-011-0695-y"},{"key":"2025082801205348000_12.2.e226697.6","unstructured":"England PH . 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