J Korean Soc Pediatr Nephrol.  2011 Oct;15(2):184-190.

Acute Epididymitis in Two Children with Henoch-Schonlein Purpura

• Lee KA
• Park SJ
• Shin JI

Abstract

Scrotal involvement has been reported from 2% to 38% of males with Henoch-Schonlein purpura (HSP). It may present before the rash occurs or even long time after it has disappeared. Scrotal involvement of HSP usually results in pain, tenderness, swelling or discoloration of scrotum. Scrotal pain sometimes mimics testicular torsion to various degrees, which can be followed by unnecessary operation. In our 2 cases, one was a 5-year and 11-month-old boy who came to our emergency department due to scrotal pain before the diagnosis of HSP, and the other was a 5-year and 1-month-old boy who came to the outpatient clinic due to scrotal pain after the resolution of HSP about 1 month before the visit. We performed Doppler ultrasonography (USG) to evaluate the acute scrotal pain in the two boys. On Doppler USG, epididymis showed increased blood flow, and testis showed normal blood flow. These findings enabled the diagnosis of acute epididymitis and excluded testicular torsion. Epididymitis was improved by conservative management including shortterm steroid therapy within 5 days. It is important to perform adequate evaluation with tools such as Doppler USG in the early course of acute scrotum of HSP, to avoid unnecessary scrotal exploration.

Keyword

Henoch-Schonlein purpura; Epididymitis; Doppler ultrasonography

MeSH Terms

Ambulatory Care Facilities
Child
Emergencies
Epididymis
Epididymitis
Exanthema
Humans
Infant
Infant, Newborn
Male
Porphyrins
Purpura, Schoenlein-Henoch
Scrotum
Spermatic Cord Torsion
Testis
Ultrasonography, Doppler
Porphyrins