[Scrotal tuberculosis in an immunocompetent patient: an atypical location of Koch's bacillus]

Scrotal tuberculosis is a rare infectious condition that is more common in immunosuppressed patients.

A 19-year-old patient with no known drug allergies presented with testicular pain and swelling for 2 weeks, along with significant weight loss in the last month, with no other systemic symptoms. He reported previous risky sexual relations. Acute right-sided epididymo-orchitis was initially suspected, but empirical treatments were suspended after testing negative for several STDs. However, the patient worsened, showing complicated epididymo-orchitis with fistulization and scrotal collection formation, caused by Corynebacterium jeikeium. Additional tests revealed a positive PCR for Mycobacteria tuberculosis, confirming tuberculous orchitis.

Scrotal tuberculosis is a rare infectious condition that is more common in immunosuppressed patients, characterized by the identification of the tuberculous bacillus by bacilloscopy. Early diagnostic suspicion is of vital importance, especially in immunosuppressed patients with urinary tract infection. Imaging findings are highly suggestive of this pathology and constitute the differential element for its definitive diagnosis.

Scrotal tuberculosis is an unusual pathology, but it can present high morbidity and mortality. In most cases, it has a good prognosis with antituberculosis treatment and early diagnosis.