A 38-year-old cisgender man from India is evaluated during a primary care visit for a 4-month history of discomfort in his right scrotal area. On physical examination, there is tenderness throughout the right scrotum and right epididymis, but with minimal swelling. He denies fever, chills, or other genitourinary or systemic symptoms. During the past 10 years, his only sexual activity has involved vaginal intercourse with his wife. He has no other medical problems and takes no medications aside from a daily multivitamin. He was raised in India and came to the United States at the age of 29 years. He visits his family in India every few years, but otherwise denies recent travel.