Epididymitis

Question 1

Causes of acute epididymitis?

Answer 1

In sexually active men: chlamidya, gonorrhoea, mycoplasma genitalium.

Amiodarone

Non sexually transmitted: E.coli

TB epididymitis in endemic areas

Question 2

How does epididymitis present?

Answer 2

Unilateral pain and swelling of scrotum gradual onset, <6 wks duration.
Dragging/heavy sensation.
Urethral discharge (think STI)
Common in 19-25 yrs.
Tender, hot and erythematoud hemiscrotum.

May have features of LUTI

Question 3

Investigations for epididymitis?

Answer 3

Urethral swab if sx of urethritis.
Urine dip and MCS.
Chlamydia and gonorrhea NAAT testing.
Charcoal swab (for testing thrush, BV)

Question 4

How to manage epididymitis?

Answer 4

Gonorrhoea/chlamydia: doxycycline 10/7, + azithromycin + ceftriaxone stat

Enteric organism induced: levofloxacin 10/7

Supportive: simple analgesia, best rest & scrotal elevation