A case of isolated testicular Tuberculosis: Approach and management

Testicular tuberculosis is a rare form of genitourinary TB that often mimics conditions such as neoplasms or chronic epididymo-orchitis, making diagnosis challenging. We report a 60-year-old man with longstanding right testicular pain and swelling, no systemic symptoms, and a history of household TB exposure. Imaging showed a large hydrocele with suspected underlying pathology. Intraoperative findings revealed necrotic testicular tissue, prompting orchiectomy. Histopathology confirmed granulomatous inflammation with caseous necrosis consistent with TB. The patient began standard anti-tubercular therapy. This case highlights the need to consider testicular TB in chronic scrotal swelling, particularly in TB-endemic settings.