Henoch-Schönlein Purpura Presenting With Orchitis: A Case Report and Review of the Literature
Henoch-Schönlein purpura (HSP) is the most common cause of nonthrombocytopenic purpura in children. The clinical picture is classically a cutaneous purpuric eruption of the legs and buttocks and infrequently the upper torso and extremities. Arthritis, gastrointestinal tract symptoms, and nephritis are other common findings typically associated with the cutaneous findings. We present an unusual case of HSP with scrotal swelling and orchitis.
The typical clinical picture of a patient with HSP is a purpuric eruption on the lower extremities and buttocks with arthritis, gastrointestinal tract symptoms, and varying amounts of renal disease. We report the presentation of HSP with an acute scrotum. In our case, based on the presence of bilateral scrotal pain, classic cutaneous findings, and Doppler and gray-scale ultrasound findings consistent with orchitis, a diagnosis of HSP orchitis was made and unnecessary surgery was avoided. Furthermore, the use of a short course of oral steroid therapy seemed to hasten the relief of the patient's scrotal and cutaneous symptoms. This report illustrates an unusual presentation of HSP.
