Emphysematous epididymitis following hydrocelectomy

Abstract Acute epididymo-orchitis is an inflammatory process caused by bacterial infection. Emphysematous epididymitis is an extremely rare manifestation characterized by gas within the epididymal tissues. We report a case of emphysematous epididymitis following hydrocelectomy in a patient with a history of spinal cord injury and chronic bacteriuria. The diagnosis was made by clinical and laboratory data with imaging demonstrating foci of gas within the epididymal structures. We hypothesize that intermittent catheterization may have contributed to bacterial translocation into the adjacent cord structures and development of infection. High level of suspicion leading to early diagnosis, aggressive antibiotics and adequate debridement are required.