Fig. 17.

Acute epididymo-orchitis in a 47-year-old Sri Lankan man with multiple myeloma on bortezomib therapy, suffering from fever and acute scrotal pain, tenderness and induration. Contrast-enhanced CT (a, b) performed to investigate impending urosepsis depicted a thickened engorged left spermatic cord, with inhomogeneous vascularisation of the ipsilateral epididymis (thin arrows) and testis (arrows). Note catheter (in a), thickened and increased oedematous attenuation of the scrotal skin and external tunicae. CD-US (c) revealed hypervascularisation of the epididymis (+). Unresponsive to antibiotics, Klebsiella pneumoniae ultimately required orchiectomy