A case of
vasculitis syndrome associated with
epididymitis is reported. A 56-year-old male presented with the sudden left testicular
pain and
fever. He came to the department of urology in our hospital, and was treated with
antibiotics and anti-tuberculous drugs. However, the testicular
pain was not relieved as well as the
fever. In January 5, 1993, he was admitted. He had lost 6 kg. Physical examination revealed
pyrexia and blood pressure of 150/91 mmHg. Laboratory finding revealed
leukocytosis,
thrombocytosis, and erythrocyte sedimentation rate of 100 mm/hr. On serological examination, the
C-reactive protein was positive. We suspected this case as a
polyarteritis nodosa, then he was given
prednisolone. On January 20, 1993, left
orchidectomy and spermatic cord biopsy was performed and non-necrotizing
vasculitis was found. On August 10, cyclophoaphamide was added and his symptom disappeared. Although
polyarteritis nodosa is well known as the
vasculitis affecting the epididymis, it was rare that initial manifestation was testicular
pain. In this case necrotizing
vasculitis was not proven, but we diagnosed this case as a
vasculitis in which the initial symptom was the
epididymitis.