Cocaine abuse that presents with acute scrotal pain and mimics testicular torsion

Vol. 42 (5): 1028-1032, September – October, 2016

doi: 10.1590/S1677-5538.IBJU.2015.0663


CHALLENGING CLINICAL CASES

José Tadeu Nunes Tamanini 1, Vagner Tadeu Salzani 1, Juliana Milhomem Tamanini 2, Filipe Iessenco 1, Leonardo O. Reis 3

1 Departamento de Medicina da Universidade Federal de São Carlos, SP, Brasil; 2 Faculdade de Medicina ABC, Santo André, SP, Brasil; 3 Departamento de Urologia da Universidade Estadual de Campinas, UNICAMP, SP, Brasil

 

ABSTRACT

Report case (s) relevant aspects: Man, 27 years old, complaining of acute testicular pain by 2 hours in the remaining left testicle. Denies fever, lower urinary tract symptoms such as dysuria, urinary frequency, concommitant or prior urethral discharge to the painful condition. He underwent right orchiectomy 13 years ago by testicular torsion. He is a chronic user of cocaine for 15 years and during the last three days the drug use was continuous and intense.

Proposed premise substantiating case (s) description:

Initial diagnostic hypothesis:

Syndromic:

Acute Scrotum Syndrome (SEA)

  • Main Etiologic (testicular torsion)
  • Secondary Etiologic (acute orchiepididymitis)

Briefly delineates what might it add? Lines of research That Could be Addressed: In this challenging clinical case we presented an alternative and new etiologic diangosis for the acute scrotum which the main etiologic factor remains testicular torsion. This new diangosis is acute testicular ischemia as a complication of cocaine abuse.

Keywords:  Spermatic Cord Torsion; Scrotum; Cocaine

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