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CASE REPORT
TB epididymo-orchitis: A rare entity reveals the cause of a falsely diagnosed "COPD disease progression"
1
Assistant Professor of Respiratory Medicine, Medical School, Aristotle University of Thessaloniki, Pulmonary Department, “G. Papanikolaou” Hospital, Thessaloniki, Greece
2
Resident of Respiratory Medicine, Respiratory Failure Unit, “G. Papanikolaou” Hospital, Thessaloniki, Greece
3
Consultant of Radiology, Radiology Department, “Agios Paulos” Hospital, Thessaloniki, Greece
4
Professor of Respiratory Medicine, Medical School, Aristotle University of Thessaloniki, Pulmonary Department, “G. Papanikolaou” Hospital, Thessaloniki, Greece
5
Professor of Respiratory Medicine and Infectious Diseases, Medical School, Aristotle University of Thessaloniki, Respiratory Failure Department, “G. Papanikolaou” Hospital, Thessaloniki, Greece
Corresponding author
Katerina Manika
Pulmonary Department, “G. Papanikolaou” Hospital, Papanikolaou Avenue, 57010, Exohi, Thessaloniki, Greece
Pulmonary Department, “G. Papanikolaou” Hospital, Papanikolaou Avenue, 57010, Exohi, Thessaloniki, Greece
Pneumon 2020;33(2):1-6
KEYWORDS
ABSTRACT
A 57-year-old male, diagnosed with chronic obstructive pulmonary disease (COPD) at the age of 49, with rapid disease progression over the last six months, presented with a palpable nodule in his right testicle which progressed to abscess not responding to common antibiotics and was finally submitted to right orchiectomy. The histology of the resected tissue revealed caseating granulomas that set the diagnosis of Tuberculosis (TB) and the patient was re-evaluated for the deterioration of his COPD. Mycobacterium tuberculosis was isolated in his sputum and he was treated successfully with six months of anti-tuberculous treatment. TB is included in the differential diagnosis of both testicular nodules and deteriorating COPD. Had TB been suspected in the patient's initial evaluation, he would have avoided a severe deterioration of his respiratory function, a high-risk surgery and an unnecessary orchiectomy.
ABBREVIATIONS
ABG: arterial blood gas, COPD: chronic obstructive pulmonary disease, CRP: c-reactive protein,
CT: computed tomography, DLCO: diffusion capacity for Carbon Monoxide, FEV1: forced expiratory
volume in 1 second, HIV/AIDS: human immunodeficiency virus/acquired immunodeficiency syndrome,
LTOT: long-term oxygen therapy, mMRC: modified medical research council, MRI: magnetic resonance
imaging, NTM: non-tuberculous mycobacteria, RV: residual volume, TB: Tuberculosis, WBC: white blood
cells, WHO: world health organization
CONFLICTS OF INTEREST
This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.
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