Granulomatous orchitis is usually accompanied by fever, pain, testicular enlargement, and tenderness in the scrotal region. Idiopathic cases are usually unilateral (more often involving the right side) but may be bilateral. The predominant histologic finding is intratubular infiltrates of epithelioid histiocytes, lymphocytes, and plasma cells. Necrosis and well-formed granulomas are usually not seen in idiopathic cases. Special stains for mycobacteria and fungal organisms are negative.