Epididymitis

Question 1

What is epididymytis?

Answer 1

Swelling, inflammation , or infection of the epididymis.

Question 2

Most cases are infections and can be divided into?

Answer 2

Sexually transmitted forms
Typically occur in men under 40
Associated with urethritis
Result from chlamydia or neisseria gonorrhea

Non sexually transmitted forms
Occur in older men
Associated with UTI and prostatitis
Caused by gram negative rods

Question 3

What is the normal route of infection?

Answer 3

Via the urethra to the ejaculatory duct

Question 4

What are some signs and symptoms of epidydimitis?

Answer 4

May follow acute physical strain, trauma, or sex.
Associated with urethritis and cystitis
Fever
Scrotal swelling is usually apparent
Early in the course the epydydimis may be distinguishable from testis

Question 5

What sign may be helpful but is not reliable?

Answer 5

Prehn sign

Question 6

What lab findings will you have with epididymitis?

Answer 6

Leukocytosis
Chlamydia or gonorrhea on NAAT on urine for st
Non st will have Pyuria, bacteiruria and varying degrees of hematuria

Question 7

What imaging should you use?

Answer 7

Scrotal ultrasound

Question 8

What is the treatment for Sexually transmitted epidydimitis?

Answer 8

Ceftriaxone 250mg IM one dose

Doxycycline 100 mg BID for 10 days

Question 9

What is the treatment for non sexually transmitted epidydimitis?

Answer 9

Bactrim 160mg tmp po every 12 hrs for three weeks

Ciprofloxacin 250-500mg po bid for three weeks

Levaquin 750mg PO daily for three weeks

Question 10

What will provide symptomatic relief?

Answer 10

Bed rest
Scrotal support
Ice packs
NSAIDS