EPIDIDYMO-ORCHITIS IN A 13-YEAR-OLD BOY DURING VARICELLA INFECTION - ULTRASOUND FOLLOW UP

Abstract

Varicella is a highly contagious infectious disease that can cause various complications. One of them, epididymo-orchitis, is rare and poorly described in literature, and thus remains seldom thought of, under-diagnosed, and poorly treated. In this report we present the case of a 13-year-old boy initially examined by an infectologist and a pediatric surgeon under the diagnosis of a scrotal bacterial superinfection during a varicella infection. Wrongly treated with antibiotics, he was then examined by a pediatric endocrinologist, diagnosed with epididymo-orchitis as a varicella complication, and treated with acetaminophen, ice packs and scrotum suspension, as the 24-hour window for antiviral therapy initiation was missed. Laboratory test showed no signs of infection, while ultrasonography showed enlargement of the right testicle and epididymis with thickening of tunica albuginea and paratesticular effusion. The ultrasound follow up then showed improvement with each examination and a year later a completely normal finding. Hormonal status was normal during the follow up, so was the sperm count. However, sperm mobility was reduced 5 years later and the patients diagnosed with asthenozoospermia. Hence we must emphasize the role of a varicella infection and its ability to leave a long term consequence to reproductive health. Having in mind the diminished antiviral therapy and still doubtful complication prevention we have to point out the prevention measures, including vaccination and the development of new antiviral methods.