Published: 2022-07-25

Isolated epididymal tuberculosis: case report and review of literature

Girum T. Assefa, Tihut Z. Asfaw


Ethiopia is one of the countries with high burden of pulmonary tuberculosis and the number of cases of extra pulmonary is increasing. However, diagnostic evidence to initiate anti-tuberculosis treatment among extra pulmonary tuberculosis (EPTB) cases is not well known. We presented here a case of isolated tuberculosis epididymitis with scrotal sinus after developing nonspecific testicular symptoms for more than 2 months and review the literature. Tuberculous epididymitis is a form of urogenital tuberculosis that is particularly rare and has the same clinical manifestation that mimics other more common infectious causes of epididymitis, leading to delay in diagnosis. So, one should maintain a high-index of suspicion to accurately diagnose tuberculous epididymitis in individuals presenting with suggestive signs and symptoms.


Epididymitis, Orchitis, Fistula, Tuberculosis, Genitourinary tuberculosis, Scrotum

Full Text:



WHO. Global Tuberculosis report 2020. Available at: Accessed on 10 May 2022.

Visweswaran RK, Pais VM, Dionne-Odom J. Urogenital tuberculosis. UpToDate. 2018.

Yadav S, Singh P, Hemal A, Kumar R. Genital tuberculosis: current status of diagnosis and management. Transl Androl Urol. 2017;6(2):222-33.

Chung JJ, Myeong-Jin K, Lee T, Yoo HS, Lee JT. Sonographic Findings in Tuberculous Epididymitis and Epididymo-orchitis. J Clin Ultrasound. 1997;25(7):390-94.

Tzvetkova P. Tuberculosis of male genital System-Myth or Reality in 21ST century. Arch Androl. 2006;52:375-81.

Horsburgh CR. Epidemiology of tuberculosis. UpToDate. 2018.

Arega B, Mersha A, Minda A, Getachew Y, Sitotaw A, Aguni TGA. Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital in Ethiopia. PLoS One. 2020;15(12):e0243945.

Hane J, Duffey B, Kaiser R, Walker PF, Alpern JD. Epididymo-Orchitis due to Mycobacterium tuberculosis. Am J Trop Med Hyg. 2019;101(5):1070-2.

Jha SK, Rathish B. Genitourinay tuberculosis. Int J Urol. 2008;15:827-32 (2008)

Muneer A, Macrae B, Krishnamoorthy S, Zumla A. Urogenital tuberculosis-epidemiology, pathogenesis and clinical features. Nat Rev Urol. 2019;16(10):573-98.

Man J, Cao L, Dong Z, Tian J, Wang Z, Yang L. Diagnosis and treatment of epididymal tuberculosis: a review of 47 cases. Peer J. 2020;10(7717):1-9.

Shenoy VP, Viswanath S, D’Souza A, Bairy I, Thomas J. Isolated tuberculous epididymo-orchitis: an unusual presentation of tuberculosis. J Infect Dev Ctries. 2012;6(1):92-4.

Suankwan U, Larbcharoensub N, Viseshsindh W, Wiratkapun C, Chalermsanyakorn P. A clinicopathologic study of tuberculous Epididymo-orchitis in Thailand. Southeast Asian J Trop Med Public Health. 2012;43(4):951-8.

Ka-Siong KV, Pei-Hui C. Isolated tuberculous epididymitis presenting as a painless scrotal tumor. J Chin Med Asso. 2012;75:292-5.

Chawla A, Chawla K, Reddy S, Arora N, Bairy I, Rao S, Hegde P, Thomas J. Can Tissue PCR Augment the Diagnostic Accuracy in Genitourinary Tract Tuberculosis. Urol Int. 2012;88:34-8.

Mahaveer J, Weston M, Wolstenhulme S. Epididymal Tuberculosis: A Diagnostic Challenge, Sonographic Findings, and Differential Diagnosis. J Diagnostic Med Sonography. 2018;34(1):59-63.

Huang Y, Chen B, Cao D, Chen Z, Li J, Guo J, Dong Q, Wei Q, Liu L. Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up. BMC Infect Dis. 2021;21:1068.