Epididymo-orchitis Flashcards
What is Epididymo-orchitis?
Inflammation of the epididymis and testicle.
What is Epididymo-orchitis due to?
Local spread of infection from the genital tract or bladder
Who is usually affected by Epididymo-orchitis?
Adult males
What are the main causes of Epididymo-orchitis if it presents in a sexually active young persion?
Chlamydia trachomatis and Neisseria gonorrhoeae
What is the main cause of epididymo-orchitis if it presents in an older person with a lesser sexual activity history?
E.coli
What are the main presenting features of epididymo-orchitis?
- unilateral testicular pain and swelling
- frequency and dysuria may be present
- Potenitally pyrexia
What might you see on examination of someone with epididymo-orchitis?
Swollen and tender testis with the treated swelling located over the epididymis
What is the most common cause of epididymo-orchitis?
E.coli
What is the most important differential diagnosis to epididymo-orchitis?
Testicular torsion
What is the maagement of it is likely an STI causing the epididymo-orchitis?
Ceftriaxone 500mg intramuscularly single dose, plus doxycycline 100mg by mouth twice daily for 10-14 days
What is the managment if E.coli is the likely cause of epididym-orchitis?
Oral quinolone for 2 weeks (e.g. ofloxacin)
If ther was discharge in someone with epididymo-orchitis, what woud be the likely cause?
Chlamydia or gonorrhoea
If ther was discharge in someone with epididymo-orchitis, what woud be the likely cause?
Chlamydia (main) or gonorrhoea
What investigations can be carried out in someone with epididymo-orchitis?
MSSU: E.coli
NAAT: Chlamydia
What are examples of quinolones that can be prescribed for e.coli caused epididymo-orchitis?
Ofloxacin for 14 days
Levofloxacin for 10 days
What are possible side effects of quinolones?
Tendon damage and tendon rupture, notably in the Achilles tendon
Lower seizure threshold (caution in patients with epilepsy)
Example of someone presenting with epididymo-orchitis?
One-sided groin pain and scrotal swelling with associated dysuria
Hemiscrotum is erythematous and tender.
Pyrexia
Elevation of the scrotal skin eases the pain.
What can help reduce the pain in someone with epididymo-orchitis?
Elevation of the scrotal skin eases the pain
How is the presenation different to testicular torsion?
Testicular torsio has a more acute onset- within hours
Epididymo-orchitis- onset over a few days
