Henoch-Schonlein purpura and epididymitis in an adult: A case report and literature review

Henoch-Schonlein purpura (HSP) is a small-vessel immunoglobulin A1-mediated vasculitis which often presents as a purpuric rash affecting the cutaneous tissue, gastrointestinal tract and joints. Commonly reported in childhood is scrotal involvement with pain and swelling, but this is exceptionally rare in the adult population. We report a case of a 33-year-old male with bilateral testicular pain and swelling on the background of concurrent HSP. The history, examination, subsequent investigations and ultrasound scan confirmed a non-bacterial and non-viral epididymo-orchitis. This was managed effectively with systemic steroids and topical emollients for symptomatic relief. This is a rare but important manifestation of HSP for clinicians assessing HSP patients with acute testicular pain.