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Emphysematous epididymitis following hydrocelectomy.

Garrick M Greear1, Seth K Bechis2

  • 1UC San Diego Health, 200 West Arbor Drive #8897, San Diego, CA, 92103-7897, USA.

Urology Case Reports
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Summary

Emphysematous epididymitis, a rare gas-forming infection, occurred after hydrocelectomy in a patient with spinal cord injury. Early diagnosis and treatment are crucial for managing this severe condition.

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Area of Science:

  • Urology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Acute epididymo-orchitis is a common bacterial infection.
  • Emphysematous epididymitis is a rare, severe manifestation involving gas in epididymal tissues.

Observation:

  • A case of emphysematous epididymitis post-hydrocelectomy in a patient with spinal cord injury and chronic bacteriuria is presented.
  • Diagnosis was confirmed via clinical, laboratory, and imaging findings showing gas in the epididymis.

Findings:

  • Intermittent catheterization is hypothesized as a potential cause for bacterial translocation and subsequent infection.
  • Gas formation within the epididymis indicates a severe infectious process.

Implications:

  • A high index of suspicion is necessary for early diagnosis of emphysematous epididymitis.
  • Prompt and aggressive treatment, including antibiotics and surgical debridement, is essential for favorable outcomes.
  • This case highlights a rare complication in patients with neurogenic bladder and chronic urinary tract infections.