Testicular tuberculosis (TB) is a rare form of genitourinary TB. It is usually presented as painful or painless testicular swelling with or without scrotal ulceration or discharging sinus. Infertility may occur. Epididymal involvement is usually seen in testicular TB. In most cases, genital TB is associated with TB involvement of kidneys or lower urinary tract. Ultrasound (USG) and USG-guided fine needle aspiration cytology of testicular swelling confirm the diagnosis. Anti-TB chemotherapy is the mainstay of treatment to ensure the complete resolution of the lesion. However, in very few cases, orchidectomy is required for both diagnosis and treatment. Here, we report a very rare case of left sided isolated testicular TB in a 20-year-old male who was completely cured with 6 months regimen of anti-TB chemotherapy.

Testicular tuberculosis (TB Orchitis) is a rare condition with a presentation that mimics testicular tumors. We present a rare case of TB orchitis in a 6-month old male infant who presented with a painless, firm left testicular mass that was initially managed as a testicular tumor but later confirmed to be TB orchitis after histological analysis. The aim of this report is to highlight the similarity of presentation between testicular TB and testicular tumors in children which may only be differentiated histologically therefore creating a diagnostic enigma.

Genitourinary TB comprises 8–15% of extra-pulmonary TB. Urinary involvement is more common than genital involvement which accounts for approximately 28% of cases and of these only 3% involve the testis. The most common site of genital TB is the epididymis in men, followed by the seminal vesicles, prostate, testis, and the vas deferens.