Epididymo-orchitis

Epididymitis – inflammation / infection of the epididymis

Orchitis – inflammation /infection of the teste

 

Causes

  • E. coli
  • Chlamydia trachomatis
  • Neisseria gonorrhea
  • Mumps

 

Presentation

Don’t miss testicular torsion as a differential, if any doubt at all – treat as torsion

  • Gradual onset over minutes / hours (as opposed to rapid onset with torsion)
  • Usually unilateral
  • Testicular pain and tenderness
  • Dragging / heavy sensation
  • Urethral discharge (think chlamydia / gonorrhea)
  • Tender on palpation, particularly over epididymis
  • Swelling of testicle and epididymis
  • Erythema to scrotum

 

Management

  • Admit and treat sepsis if septic, otherwise as outpatient
  • Antibiotics as per local guidelines (e.g. ciprofloxacin for 2 weeks)
  • Tight underwear for scrotal support during illness
  • Abstain from intercourse during illness
  • Confirm diagnosis with ultrasound of the scrotum (exclude torsion and tumours)
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