Testicular pain associated with clear fluid meningitis: How many cases of Toscana virus are we missing?

•Testicular pain is uncommonly associated with TOSV meningitis.•Around 50% of aseptic meningitis cases are considered as without etiologies.•A whole body examination is the key element in medical practice. Toscana virus (TOSV) is a common cause of meningitis in Mediterranean area. However, rare publications reported extra-meningeal signs. We report the third case of testicular pain associated with TOSV meningitis despite the fact that there is no evidence of semen involvement in other well-known arboviruses, except in Zika virus.