An Asian man initially presented with a urethral discharge caused by lower urinary tract infection, which was followed by acute epididymo-orchitis. This responded well to antibiotics but was followed by a less acute form of epididymo-orchitis, which did not respond to antibiotics and which tissue biopsy showed to be tuberculous. The inflammatory injury of acute epididymo-orchitis may have activated a silent tuberculous focus in the epididymis, which led to the subsequent subacute tuberculous epididymo-orchitis.
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