[Epididymo-orchitis in a newborn: rare illness revealing late-onset Streptococcus agalactiae meningitis]. / Orchi-épididymite néonatale : une affection rare révélatrice d'un sepsis secondaire à streptocoque du groupe B.

Acute scrotum is unusual during the neonatal period. Testicular torsion is a surgical emergency aimed at salvaging the affected testis. Epididymo-orchitis is the main differential diagnosis, but few cases have been described in the newborn. Here, we report the case of a late-preterm infant who presented with late-onset group B streptococcal sepsis revealed by unilateral epididymo-orchitis.

Clinical features of testicular torsion and epididymo-orchitis in infants younger than 3 months.

BACKGROUND/PURPOSE: Testicular torsion (TT) and orchitis/epididymo-orchitis (EO) are confusing and difficult for physicians to diagnose in infants younger than 3 months. The aim of the study was to delineate the etiology and the clinical features of TT and EO in this age group. METHODS: During the period between April 1994 and September 2004, medical charts of infants younger than 3 months with TT and EO were reviewed retrospectively. RESULTS: Sixteen patients were eligible for the study, including 9 with TT and 7 with orchitis/EO. Two infants had postnatal torsion, and the testicles were salvaged by emergent surgery. Eighty-six percent (6/7) of infants with EO/orchitis had either abnormal physical signs (fever or scrotal tenderness) or abnormal laboratory findings (leukocytosis or elevated C-reactive protein level). The sensitivity of color Doppler ultrasound to diagnose TT and EO/orchitis was 88% (7/8) and 100% (6/6), respectively. All infants (6/6) with EO/orchitis who were checked for urinary tract infection and sepsis had positive test results. CONCLUSIONS: Pediatricians should examine the testicles meticulously after a baby is born. Orchitis/EO is highly suspected for patients associated with abnormal physical signs and laboratory findings. Prompt prescription of antibiotics is mandatory to avoid serious sequelae.

Meconium periorchitis--a rare cause of a paratesticular mass.

We report a 9-month-old boy who presented with a hard paratesticular mass. Clinical and ultrasound findings were highly suggestive of malignancy and orchidectomy was performed. Histology confirmed the unexpected diagnosis of meconium periorchitis, a rare, benign condition resulting from intrauterine bowel perforation.

Scrotoschisis associated with contralateral meconium periorchitis.

Scrotoschisis, a congenital defect of the scrotal wall associated with extracorporeal testicular ectopy, has been previously reported only twice. Meconium periorchitis is another rare scrotal anomaly indicative of an antenatally healed gastrointestinal perforation. The authors present a third case of scrotoschisis and the first associated with meconium periorchitis. Several hours after birth of an otherwise-normal term baby boy, a scrotal exploration was performed with orchidopexy and primary closure of the scrotal wall defect. At 4 months of age the baby underwent a contralateral inguino-scrotal exploration with excision of a paratesticular mass of calcified meconium. The role of a normally developed scrotum in testicular descent and causes of calcified scrotal masses in infants are discussed.