A cautionary tale of an unfortunate testis: Testicular infarction and rupture as a rare complication of acute epididymitis

Epididymo orchitis is a common cause of unilateral scrotal pain. Infection is caused by retrograde ascent of pathogens to the epididymitis and extension to the testis. This condition typically follows an indolent course and responds well to a course of culture directed antibiotics along with analgesiaand scrotal support. Albeit rare, more severe complications such as abscess formation, testicular infarction, and testicular loss are still possible despite receiving appropriate extended antibiotic therapy. A high index of suspicion of these complications should be maintained in any presentation of acute scrotum, as early recognition could allow for salvage of the testis. We hereby present a rare case of acute epididymo-orchitis progressing to testicular infarction and rupture in a 50 year old male.