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)