Epididymitis Flashcards

1
Q

What causes epididymitis?

A
  • can be trauma, but usually 2/2 infx
  • potential complication of STD
  • non-sexually transmitted infectious epididymitis mainly in middle aged or older men and caused by coliform bacteria or Pseudomonas
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2
Q

Clinical Presentation of Epididymitis

A
  • unilateral pain and swelling of scrotum
  • fever
  • urethral discharge
  • signs and sxs of UTI or prostatitis can also be present
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3
Q

Diagnosis of Epididymitis

A
  • culture voided urethral and midstream specimens

- tailor abx therapy to specific organisms

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4
Q

Epididymitis Pathogens in Pts < 35 Years

A
  • N. gonorrhoeae
  • C. trachomatis
  • sometimes Enterobacter
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5
Q

Tx of Epididymitis in Pts < 35 (gonorrhea, c. trachomatis)

A
  • ceftriaxone 250 mg IM x1 PLUS

- doxycycline 100 mg po bid x10 days

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6
Q

Non-Pharm Tx for Epididymitis in Pts <35

A
  • bedrest
  • scrotal elevation
  • analgesics
  • treat partners
  • test for HIV and syphilis
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7
Q

Epididymitis Pathogens in Men >35 or MSM

A

Enterobacteriaceae

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8
Q

Tx of Epididymitis in Men >35 or MSM

A

-levofloxacin 500-750 mg IV/po qd OR
-cipro 500 mg po bid or 400 mg IV bid
x10-14 days

-alt: amp/sulbactam, ticarcillin/clav, pip/tazo, cefotaxime, ceftriaxone

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9
Q

Supportive Care for Epididymitis

A
  • analgesics PRN
  • rest in bed with legs slightly apart
  • rest testes on towel roll
  • scrotal support when sitting, standing, walking
  • wear non-constrictive, lightweight clothing until swelling subsides
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10
Q

What is expedited partner therapy?

A

-partners of pts who test positive for chlamydia or gonorrhea are provided medications w/o prior medical evaluation

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11
Q

In addition to the medication, what should be provided with expedited partner therapy?

A
  • treatment instructions
  • warnings about taking the meds (if pregnant or allergies)
  • general STI health education/counseling
  • statement advising that partner seek personal medical evaluation
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12
Q

Pros of Patient Delivered Partner Therapy

A
  • promising option for controlling STI occurrence

- ANA recognized benefits and recommends PDPT when tx of partners can’t be accomplished by other means

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13
Q

Cons of PDPT

A
  • potential liability in providing tx for unseen pts
  • does not allow screening partner for other STIs, HIV, pregnancy
  • legality of PDPT not clear in many states
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