Acute Scrotum: Epididymo-Orchitis

Question 1

causes?

Answer 1

• pre-pubertal- mainly viral
• otherwise bacterial:
  
  • E.Coli
  • Chlamydia
  • Neisseria
  • Mumps

Question 2

Presentation?

Answer 2

don’t miss torsion as ddx - if in any doubt treat as torsion

• gradual onset over mins /hours
• usually unilateral
• testicular pain and tenderness
• tender on palpation
• scrotal erythema
• swelling of testicle & epidiymis
• dragging /heavy sensation
• if urethral discharge think chalmydia / gonorrhoea

Question 3

Mx?

Answer 3

• admit & treat sepsis if septic, otherwise as outpatient
• Abx as per guidelines
• abstain from intercourse during illness
• confirm diagnosis w US of scrotum
  
  • exclude torsion and tumours