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Case Reports in Urology
Volume 2013, Article ID 645787, 3 pages
http://dx.doi.org/10.1155/2013/645787
Case Report

Multidrug Resistant Epididymitis Progressing to Testicular Infarct and Orchiectomy

1University of Pittsburgh, Graduate School of Medicine, 401 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, USA
2Department of Urology, University of Pittsburgh Medical Center, 5200 Centre Avenue, Suite 209, Pittsburgh, PA 15232, USA

Received 22 August 2013; Accepted 24 October 2013

Academic Editors: I. Hara and F. Koga

Copyright © 2013 Nicholas J. Farber et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Global testicular infarction is a rare sequela of infectious epididymitis, with few reports in the urologic literature since the introduction of fluoroquinolones in the late 1980s. Ischemia occurs secondary to inflammation and edema of the spermatic cord with compression of arterial flow. We report a case of multidrug resistant epididymitis following prostate biopsy that progressed to global testicular infarction requiring orchiectomy. This case highlights the fact that epididymitis does not always follow an indolent pathway to resolution. Progression of pain should prompt early imaging and intervention. It further highlights the potential urologic consequences of the rising prevalence of multidrug resistant bowel flora in the United States, which will increasingly influence the management of presumed uncomplicated epididymitis, whether being primary or postprocedural.