RESUMEN
Segmental testicular infarction is a relatively rare acute or subacute condition that is often overlooked in the differential diagnosis of testicular pain. Ultrasound is highly sensitive in detecting testicular damage. Combining testicular tumour markers with MRI can effectively identify tumours and infarctions. Conservative treatment programs for adolescents suggest that testicular function should be monitored. We report the case of a 12-year-old boy with testicular infarction who was treated with antibiotics, dexamethasone, and vitamin C. We monitored reproductive hormones, inhibin B, anti-Müllerian hormone, and testicular volume to assess the patient's testicular function. LH increased 3.02 fold on day 14 and 3.8 fold on day 42; T increased 6.92 times on day 14 and 7.95 fold on day 42; inhibin B increased 2.72 fold on day 14 and 4.06 fold on day 42; the left testicular volume increased 1.14 fold on day 42; the right testicular volume decreased by 8 %; and the infarct area decreased by 71 %. This case study demonstrated the effectiveness of conservative treatment with antibiotics, dexamethasone, and vitamin C for segmental testicular infarction. Close monitoring of testicular function is essential for optimal management of this rare condition in adolescent patients.
RESUMEN
Epididymal orchitis is a common urological condition for which medical management is the primary treatment strategy. Although Pseudomonas aeruginosa is a common cause of nosocomial urinary tract infections, it rarely causes acute epididymal orchitis in adolescence and is difficult to treat. Furthermore, it may progress to potentially fatal complications such as global testicular infarction and late atrophy. Urinary tract infection(s) can harm the gonads and is a well-known cause of male infertility. This case study involved a 13-year-old boy with acute epididymal orchitis caused by P. aeruginosa infection, which led to testicular infarction. Testicular volume, and anti-sperm antibody, reproductive hormone, and serum inhibin B levels were monitored for six months, which revealed that left testicular volume was 1/20 of that of the right. Anti-sperm antibodies were negative, oestradiol level was elevated, but serum inhibin B level declined. This case report emphasises the importance of early treatment by implementing the use of antibiotic(s) to maximise the opportunity for testicular rescue. Testicular function on the healthy side must be monitored when testicular necrosis is detected.