Disseminated histoplasmosis presenting as granulomatous epididymo-orchitis

Genital involvement is an unusual manifestation of histoplasmosis. We report a case of histoplasmosis presenting as granulomatous epididymo-orchitis and review 4 cases reported in the literature. Diagnosis of this infection is suggested by a compatible clinical picture and results of specific serology or antigen testing, but confirmation ultimately requires analysis of pathologic specimens. Surgical drainage or resection of involved tissues and systemic antifungals typically result in resolution of infection and improved outcomes.