Acute Epididimitis And Orchitis Flashcards
What is Orchitis
Inflammation of one or both testicles
What is the most common causes of epididymitis and orchitis in young men vs older men
N. gonorrhoeae & C. trachomatis
• <35 years old
Escherichia coli & Pseudomonas spp.
• Older men
S/S of epididymitis
Testicular pain, tenderness, and swelling
Tender epididymis
S/S of Orchitis
Gradual onset scrotal pain & swelling, Unilateral
Generalized inflammation that spreads to adjacent testicle
Pain radiation to lower abdomen
S/S of epididmyitis-orchitis
• Sitting is uncomfortable
• Scrotal wall erythema
• Reactive hydrocele
• Systemic signs: Urinary retention among elderly
• Prehn’s Sign: Partial or complete relief of pain, Suggest of epididymitis
What is the empiric treatment plan for high risk STI epididymitis or orchitis
Cover N. gonorrhoeae and C. trachomatis
• Ceftriaxone 250 mg IM x1 plus Doxycycline 100 mg PO BID x10
days
Azithromycin 1 g orally x1 dose
Avoid fluoroquinolones: Gonorrhea widespread resistance
What is the empiric treatment for low risk STI in Epididymitis and Orchitis
Low risk for STI
• Levofloxacin 500 PO QD x10 days
• Bactrim DS BID x10 days
• Insertive anal intercourse
• Cover for N. gonorrhoeae, C. trachomatis, and enteric pathogens
• Ceftriaxone 250 mg IM x1 dose plus Levofloxacin 500 mg PO
QD x10 days