Tuberculous epididymo-orchitis presenting within the setting of a sexually transmitted disease clinic

Background: Tuberculous epididymo-orchitis (TBEO) is uncommon in Western cities in the modern era. A case series of 3 patients with TBEO presenting to a sexually transmitted diseases (STD) clinic has never previously been reported. Goal: The goal of this study was to report all known cases of TBEO attending a London STD clinic within the last 6 years. Study Design: We conducted a case analyses. Results: The 3 patients aged 30, 42, and 47 years were all HIV-negative and immigrants (2 black Africans, 1 Middle Eastern). The median duration of scrotal swelling was 3 months (range, 2-4 months). Mycobacterium tuberculosis was isolated from early-morning urine specimens in 2 of 3 cases. All had grade IV Heaf test (equivalent to greater than 15 mm Mantoux induration), unilateral TBEO without renal tract disease, and responded to antituberculous chemotherapy. Conclusion: The changing epidemiology of TB and demography of Western countries could lead to an increase in such patients presenting at STD clinics. The early diagnosis of TBEO, which is aided by clinical acumen and conventional diagnostic tools, can prevent complications.