Epididymo-orchitis

Question 1

what

Answer 1

infection of epididymis and testicle on one side

Question 2

causes

Answer 2

e.coli
chlamydia
gonorrhoea
mumps

Question 3

when to think of mumps

Answer 3

parotid gland swelling + orchitis

Question 4

presentation

Answer 4

gradual onset and unilateral symptoms

• testicular pain
• dragging sensation
• swelling
• tenderness
• urethral discharge
• fever

Question 5

key differential diagnosis

Answer 5

testicular torsion

Question 6

features that make STI more likely

Answer 6

< 35yrs
inc no. sexual partners
urethral discharge

Question 7

Ix

Answer 7

urine MC&S
chlamydia and gonorrhea NAAT tesitng
charcoal swab
USS

Question 8

Mx - high risk STI

Answer 8

refereal to GUM

Question 9

Mx - low risk STI

Answer 9

ofloxacin 14days

or
levofloxacin, ciprofloxacin
doxycycline
co-amoxiclav

Question 10

quinolone antibioitcs

Answer 10

e.g. ofloxaxin, levofloxacin, ciprofloxacin

broad spectrum
gram negative cover

Question 11

quinolone antibioitcs - side effects

Answer 11

tendon damage and rupture, notably achilles tendon

low seizure threshold - caution in patients with epilepsy

Question 12

complications

Answer 12

chronic pain 
chronic epididymitis
testicular atrophy 
sub-fertility 
scrotal abscess