{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T21:13:37Z","timestamp":1789161217181,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tuberculosis (TB) remains a global health concern, and while primarily affecting the lungs, extrapulmonary manifestations such as genitourinary tubercular epididymitis are rare and diagnostically challenging. Accurate differentiation is crucial for appropriate treatment. This case study presents a 34-year-old man with left scrotal swelling, backache, and fever, highlighting the importance of considering TB in genitourinary conditions. High-resolution sonography revealed an edematous left testis with increased vascularity and hypoechoic nodules. Further imaging, including high-resolution computed tomography thorax and CEMRI dorso-lumbar spine, confirmed disseminated TB. Despite negative urine culture, aspiration cytology from the epididymal collection indicated tubercular etiology. Urogenital TB, especially isolated epididymal involvement without renal effects, presents diagnostic challenges, often occurring in immunocompromised patients. The case underscores the role of clinical, biochemical, and radiological evidence in establishing a correct diagnosis. High-resolution ultrasonography plays a crucial role in diagnosing scrotal pathologies, and when accompanied by an epididymal collection, further diagnostic steps involving biochemical parameters and aspiration followed by cytoanalysis and culture are essential. The diagnosis of TB epididymitis can be confirmed through acid-fast bacilli (AFB) identification, positive AFB culture, or granulomas seen in a biopsy specimen in the right clinical context. Radiological imaging aids in detecting local and disseminated disease forms, including complications such as hydrocele, testicular calcifications, scrotal abscesses, sinus tracks, and fistulous communications.<\/jats:p>","DOI":"10.4103\/jmu.jmu_28_24","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T17:12:06Z","timestamp":1742663526000},"page":"282-284","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Epididymo-orchitis with Epididymal Abscess in a Patient with Disseminated Tuberculosis: A Case Report"],"prefix":"10.4103","volume":"33","author":[{"given":"Vishal","family":"Kumar","sequence":"first","affiliation":[{"name":"Department Radio-Diagnosis, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basanta Manjari","family":"Swain","sequence":"additional","affiliation":[{"name":"Department Radio-Diagnosis, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangram","family":"Panda","sequence":"additional","affiliation":[{"name":"Department Radio-Diagnosis, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhanshu Sekhar","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Department Radio-Diagnosis, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"R1-20250919","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0022-5347(17)52259-4","article-title":"Tuberculous epididymo-orchitis: A case report","volume":"129","author":"Stein","year":"1983","journal-title":"J Urol"},{"key":"R2-20250919","first-page":"109","article-title":"Isolated tuberculous epididymitis: A review of forty cases","volume":"51","author":"Viswaroop","year":"2005","journal-title":"J Postgrad Med"},{"key":"R3-20250919","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1128\/jcm.30.1.255-258.1992","article-title":"Use of polymerase chain reaction for rapid diagnosis of tuberculosis","volume":"30","author":"Cousins","year":"1992","journal-title":"J Clin Microbiol"},{"key":"R4-20250919","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00006454-198501000-00015","article-title":"Tuberculous epididymitis as a cause of testicular pseudomalignancy in two young children","volume":"4","author":"Cabral","year":"1985","journal-title":"Pediatr Infect Dis"},{"key":"R5-20250919","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/j.1464-410X.1954.tb04736.x","article-title":"The blood supply of the epididymis in man","volume":"26","author":"MacMillan","year":"1954","journal-title":"Br J Urol"},{"key":"R6-20250919","doi-asserted-by":"crossref","first-page":"27","DOI":"10.25259\/JCIS-14-2019","article-title":"\u201cThe great masquerader\u201d: Sonographic pictorial review of testicular tuberculosis and its mimics","volume":"9","author":"Nepal","year":"2019","journal-title":"J Clin Imaging Sci"},{"key":"R7-20250919","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1016\/j.urology.2004.10.029","article-title":"Epididymal tuberculosis: Case report and review of the literature","volume":"65","author":"Madeb","year":"2005","journal-title":"Urology"},{"key":"R8-20250919","doi-asserted-by":"crossref","first-page":"180","DOI":"10.14366\/usg.15075","article-title":"Ultrasonography of the scrotum in adults","volume":"35","author":"K\u00fchn","year":"2016","journal-title":"Ultrasonography"},{"key":"R9-20250919","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4103\/ua.ua_12_21","article-title":"Isolated tuberculous orchitis presented as epididymo-orchitis: An unusual presentation of tuberculosis","volume":"14","author":"Mehboob","year":"2022","journal-title":"Urol Ann"},{"key":"R10-20250919","first-page":"1597","article-title":"Tuberculosis: 6. Extrapulmonary disease","volume":"160","author":"Fanning","year":"1999","journal-title":"CMAJ"},{"key":"R11-20250919","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1148\/rg.2017160164","article-title":"Testicular seminoma and its mimics: From the radiologic pathology archives","volume":"37","author":"Marko","year":"2017","journal-title":"Radiographics"},{"key":"R12-20250919","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s00345-019-02767-x","article-title":"Challenges in urogenital tuberculosis","volume":"38","author":"Kulchavenya","year":"2020","journal-title":"World J Urol"}],"container-title":["Journal of Medical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmu.jmu_28_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:21Z","timestamp":1786647321000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmu.jmu_28_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jmu.jmu_28_24","relation":{},"ISSN":["0929-6441","2212-1552"],"issn-type":[{"value":"0929-6441","type":"print"},{"value":"2212-1552","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]},"assertion":[{"value":"2024-03-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}