A 27-year-old man presents with a 3-day history of progressive tenderness and diffuse pain in his right scrotum, as well as moderate dysuria. Physical examination reveals extreme tenderness along the posterolateral aspect of the right testicle. No urethral discharge is noted. He is not taking any medication and denies recent trauma or prior genitourinary procedures or operations. He reports both receptive and insertive condomless anal intercourse with men. He denies fever, chills, hematuria, or other systemic symptoms. He tested negative for HIV approximately 6 months prior.