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SARS-CoV-2-Associated Obliterative Arteritis Causing Massive Testicular Infarction.

Dámaso Parrón¹, Ane Gartzia¹, Ane M Iturregui²

¹Department of Pathology, Cruces University Hospital, Barakaldo, 48903 Bizkaia, Spain.

Clinics and Practice

|June 2, 2021

Summary

Severe testicular infarction occurred in a 26-year-old man with SARS-CoV-2 infection. The condition, caused by obliterative arteritis linked to the virus, led to orchiectomy.

Keywords:

COVID-19 SARS-CoV-2 arteritis pathology testicular infarction

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Area of Science:

Pathology
Virology
Urology

Background:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can manifest with diverse clinical presentations.
Testicular complications are rare but serious sequelae of viral infections.

Observation:

A young adult male with symptomatic SARS-CoV-2 infection presented with acute testicular pain.
Diagnostic imaging revealed massive testicular infarction, necessitating surgical intervention (orchiectomy).

Findings:

Histopathological examination of the orchiectomy specimen showed complete testicular necrosis and obliterative arteritis.
Immunohistochemistry confirmed the presence of SARS-CoV-2 spike antibodies within the arterial endothelium.
Electron microscopy identified viral particles within endothelial cells, suggesting direct viral involvement.

Implications:

This case highlights a potential direct vascular complication of SARS-CoV-2 infection affecting the testes.
Obliterative arteritis induced by SARS-CoV-2 may lead to testicular infarction.
Further research is warranted to understand the mechanisms and prevalence of such testicular complications.