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Diagnostic Challenges in Acute Infantile Epididymitis: A Case Report
Manabu Watari1, Shohei Yoshimura2,3, Hiroyuki Nagao1
1Department of Pediatrics, Takatsuki General Hospital, Takatsuki, JPN.
Cureus
|May 15, 2025
Summary
Acute epididymitis in infants is a rare cause of acute scrotum, often mimicking surgical emergencies. Early diagnosis via ultrasound and urinalysis is key to preventing complications.
Area of Science:
- Pediatric Urology
- Emergency Medicine
- Neonatal Care
Background:
- Acute epididymitis presents diagnostic challenges in infants due to similar symptoms to surgical emergencies like strangulated inguinal hernia and testicular torsion.
- Differentiating these conditions is crucial for appropriate and timely management in the emergency department.
Observation:
- Two infant cases of acute epididymitis are presented, highlighting diagnostic difficulties.
- Case 1 involved a misdiagnosis of strangulated inguinal hernia, while Case 2 required surgical exploration to exclude testicular torsion.
Findings:
- Scrotal ultrasonography, urinalysis, and clinical evaluation aided in diagnosing epididymitis.
- Serum C-reactive protein levels can also assist in diagnosis.
- Surgical exploration proved valuable in one case for definitive diagnosis.
Implications:
- Accurate and early diagnosis of acute epididymitis in infants is vital to avoid long-term complications.
- A combination of imaging, laboratory tests, and clinical assessment is recommended.
- Surgical exploration remains a useful tool when diagnosis is uncertain.
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