Bilateral epididymal Candida abscesses: sonographic findings and sonographically guided fine-needle aspiration

We report the case of a 67-year-old diabetic man who presented 2 months after transurethral prostate surgery with impaired consciousness, urinary incontinence, and recurrent urinary tract infections that did not respond to antibiotic treatment. Sonographic findings suggested abscess formation (enlarged, heterogeneous epididymides and a central hypoechoic area in the head of the left epididymis). Aspirates obtained from sonographically guided needle biopsy were purulent. Staining showed budding yeast forms, and Candida albicans grew in culture. Systemic candidiasis was diagnosed. The patient underwent bilateral epididymo-orchiectomy, and pathologic analysis of resected specimens showed bilateral epididymal necrosis and disseminated abscess formation.