Candida albicans Epididymo-Orchitis and Fungemia in a Patient with Chronic Myelogenous Leukemia

The fourth reported case of candidal epididymo-orchitis in the literature and the first reported case successfully cured with only low dose amphotericin B is described. A 75-year-old male with chronic myelogenous leukemia presented with acute testicular and epididymal swelling and pain. Subsequent investigations suggested the diagnosis of epididymo-orchitis due to Candida albicans. This was successfully treated with intravenous amphotericin B (total dose of 500 mg). Based on the three previous case reports and the current case several characteristic features that increased the suspicion of this entity were identified. These features include an immunocompromised state, candiduria, specific epididymal ultrasonographic appearance, as well as typical clinical features of epididymo-orchitis.