Testicular Coccidioidomycosis as the initial manifestation of disseminated disease

A 70 year-old male farmer and carpenter, presented to the Emergency Department from our Hospital in Northern Mexico with a 6 month history of a painless, right scrotal mass. The patient referred 3 recurrent urinary tract infections one year before with associated mild obstructive symptoms. A primary care physician evaluated him 2 weeks before, and initiated a course of empiric antibiotics with Levofloxacin. After 10 days of therapy without improvement he was referred to our clinic. His personal history revealed Rheumatoid Arthritis since 1995 under chronic treatment with Methotrexate and Prednisone, Benign Prostatic Hyperplasia with a Transurethral Resection of Prostate in 2016 and Pulmonary Tuberculosis (TB) in 1981 treated with antituberculous drugs with two systemic reactivations: 1) perianal abscess caused by TB in 1986 and 2) laryngeal TB in 2002 requiring tracheostomy with decannulation later in 2003, he completed therapy and was considered disease free since 2004.

Source: Urology - September 22, 2019 Category: Urology & Nephrology Authors: Pedro A. Madero-Morales, Efrain Ruiz-Galindo, J. Gustavo Arrambide-Herrera, J. Iv án Robles-Torres, Raquel Guajardo-Garza, Eirali G. García-Chapa, Lauro Salvador Gómez-Guerra, Gustavo Arrambide-Gutiérrez Source Type: research