Presentation
Fever and testicular pain.
Patient Data
Unremarkable testicular ultrasound.
Ultrasound through the left testis demonstrates a rounded heterogeneous region, predominantly of low echogenicity, situated towards the upper pole of the left testis, which measures 2.6 x 1.6 cm axially x approximately 1.3 cm longitudinally. It shows no evidence of vascular flow centrally within it.
The remainder of the left testis demonstrates normal echogenicity and relatively increased vascularity with low resistive waveform of intratesticular arteries. There is only a small hydrocele on the left. The left epididymis appears normal. Features, in the setting of infective symptoms, is consistent with a testicular abscess.
Normal right testis.
Scan obtained for the left testis following 8 weeks of IV antibiotics revealed parenchymal vascularity back to normal and a peripheral subcapsular residual wedge shaped hypoechoic zone with less vascularity.
Case Discussion
Features, in the setting of infective symptoms, is consistent with a testicular abscess.
Initial ultrasound performed at onset of symptoms was largely unremarkable. The patient returned 3 days later for repeat imaging with increasing symptoms.
The patient was managed with antibiotics and improved both clinically and on imaging (8 weeks later).