Acute Epididimitis And Orchitis Flashcards

1
Q

What is Orchitis

A

Inflammation of one or both testicles

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2
Q

What is the most common causes of epididymitis and orchitis in young men vs older men

A

N. gonorrhoeae & C. trachomatis
• <35 years old
Escherichia coli & Pseudomonas spp.
• Older men

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3
Q

S/S of epididymitis

A

Testicular pain, tenderness, and swelling
Tender epididymis

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4
Q

S/S of Orchitis

A

Gradual onset scrotal pain & swelling, Unilateral
Generalized inflammation that spreads to adjacent testicle
Pain radiation to lower abdomen

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5
Q

S/S of epididmyitis-orchitis

A

• 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

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6
Q

What is the empiric treatment plan for high risk STI epididymitis or orchitis

A

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

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7
Q

What is the empiric treatment for low risk STI in Epididymitis and Orchitis

A

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

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