Isolated testicular tuberculosis: A case report

Genitourinary tuberculosis (GUTB) constitutes 20% of extrapulmonary TB cases, with isolated testicular involvement being rare (2-4%). This case details a 41-year-old male with chronic left scrotal swelling, fistulization, and purulent discharge, ultimately diagnosed with testicular tuberculosis. Diagnostic imaging and histopathology confirmed caseating granulomas and acid-fast bacilli. The patient underwent high inguinal orchidectomy and was treated with a standard four-drug anti-tuberculosis regimen. Postoperative semen analysis revealed persistent azoospermia, indicating permanent fertility impairment. This case underscores the importance of considering GUTB in differential diagnoses of testicular masses, particularly in TB-endemic regions. • Rare case of testicular tuberculosis in a 41-year-old with chronic scrotal swelling and purulent discharge. • Diagnosis confirmed via histopathology showing caseating granulomas and acid-fast bacilli. • Persistent azoospermia post-treatment highlights potential for permanent fertility impairment.