Concurrent Testicular Torsion and Epididymo-orchitis in An Untreated HIV-Positive Patient: A Case Report

Introduction. Testicular torsion may mimic epididymo-orchitis, leading to delayed diagnosis and irreversible ischemic injury. Overlapping clinical features of epididymo-orchitis and torsion may obscure diagnosis, particularly in immunocompromised patients. Case. A 23-year-old male presented with progressive left testicular pain, swelling, fever, and nausea. During hospitalization, he was diagnosed with HIV using a serial rapid testing algorithm. Physical Scrotal examination revealed edema of the left hemiscrotum with tenderness and negative Prehn’s sign. Laboratory findings demonstrated leukocytosis and bacteriuria. Color Doppler ultrasonography showed absent intratesticular blood flow and a whirlpool sign. Surgical exploration confirmed 270-degree left testicular torsion with necrosis requiring orchiectomy. Histopathological examination demonstrated chronic suppurative epididymitis. Conclusion. The presence of infection does not exclude testicular torsion. Early recognition and prompt surgical intervention remain essential to prevent irreversible testicular damage.