Condition- Epididymitis and Orchitis Flashcards
With what comorbidity does orchitis always present?
Epidydimitis
What is epididymitis and what is orchitis?
- epididymitis = inflammation of the epididymis
- orchitis = inflammation of the testes
What are the most likely infective causes of epidydimitis/orchitis in <35s?
Chlamydia and gonorrhoeaeare (+ E.Coli if homosexual)
What are the most likely infective causes of epidydimitis/orchitis in >35s?
Coliforms:
Enterobacter, Klebsiella
Which differential must be urgently excluded when investigating someone for tender swelling of the scotum
Testicular torsion- to prevent ischemia of testicles
How do you distinguish epidydmitis/orchitis from testicular torsion?
Testicular torsion has very sudden onset of symptoms, patients <20years
List some presenting symptoms of epididymo-orchitis
PAINFUL, SWOLLEN + TENDER TESTIS/EPIDIDYMIS OF SUDDEN ONSET
- sudden but not acute onset- like testicular torsion
- May get urethral discharge
- Dysuria
- Sweats + fever
- Difficulty walking
- should ask about sexual history
List some signs of epididymo-orchitis on physical examination
- swollen + tender
- oedematous + erythematous scrotum
- cremasteric reflex = painful
- pyrexia
State a key investigation to conduct on someone with epididymo-orchitis
Urine dipstick + MSU
MC&S
Which antibiotics should you give to an under 35yr old with epididymo-orchitis? and why?
doxycycline (for chlamydia)
and
ceftiaxone (for gonorrhoea)
Which antibiotics should you give to an >35yr old with epididymo-orchitis? and why?
ciprofloxacin or ofloxacin
(often caused by UTI so this covers enteric organism)
List two complications of epididymo-orchitis? What is the most likely complicaitons?
Testicular abscess
Fournier’s gangrene
What are the complications of mumps orchitis?
Testicular atrophy
Infertility
