Idiopathic testicular infarction initially masquerading as urolithiasis and epididymitis

Idiopathic testicular infarction is a rare cause of acute scrotal pain and usually misdiagnosed as other more common diseases because of similar manifestations. We present a case that was initially misdiagnosed as urolithiasis and acute epididymitis. Correct diagnosis was made only after repeated color Doppler ultrasonography and surgical exploration. This reminds us to keep alert for such patients because delayed or false diagnosis would result in unnecessary antibiotics use, patient suffering, and even orchiectomy. If diagnosis remains uncertain after clinical evaluation, early surgical exploration is suggested.