Infant boy B, on initial examination in the newborn nursery, is noted to have a large right hydrocele, which transilluminates. The left testicle is small, indurated, and nontender on palpation. The remainder of the infant's examination is within normal limits. An ultrasound is ordered to evaluate the testes.

Infant boy B weighs 3,930 g and was born via normal spontaneous vaginal delivery at 41 weeks’ gestation to a 21-year-old gravida 2 para 1 mother with history of anemia. Maternal prenatal laboratory tests show immunity to rubella and negative serology results for hepatitis B surface antigen, syphilis, and HIV. Group B strep culture is negative within 5 weeks of delivery. First and second trimester sonograms showed no abnormalities. The third trimester sonogram performed at weeks gestational age was notable for a right hydrocele measuring 3.9 × 2.5 cm. No other anomalies noted. Maternal medications included prenatal vitamins. Father and mother of...

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