Autoimmune diseases can affect the blood vessels, causing systemic vas
culitis. Although testicular manifestation of some autoimmune diseases
is not uncommon, only a few cases of acute orchitis are described in
the literature. The underlying pathological condition in testicular ma
nifestations of autoimmune diseases is severe vasculitis causing infla
mmation and infarction. In patients with recurrent episodes of scrotal
swelling and pain, testicular vasculitis as the first sign of a syste
mic disease should be taken into consideration.