Epididymo-orchitis Flashcards
What does orchitis refer to?
Inflammation of the testicle
What is the epididymis
A long tube that stores sperm and drains into the vas deferens
What are the causative organisms?
E.coli
Chlamydia trachomatis
Neisseria gonorrhoea
Mumps
How does it present? How quickly ? What symptoms?
Gradual over minutes to hours
Unilateral
Testicular pain
Dragging or heavy sensation
Tenderness on palpation particularly over epididymis
Urethral discharge - STI
Systemic symptoms
What is the key differential?
Testicular torsion
What features make STI more likely?
<35 yrs
increased number of sexual partners in last 12 months
discharge from urethra
What investigations would you do ?
Urine MCS
NAAT testing of first pass urine
Charcoal swab of purulent discharge for gonorrhoea culture and sensitivities
Saliva swab for pCR for mumps
Serum abs for mumps
USS
What is management?
Admit if acutely unwell
Refer to GUM if ?STI
Abx
What abx are usually given if likely enteric organism
Ofloxacin 14 days
levofloxacin 10 days
Co-amoxiclav 10 days
What would you advise the patient as part of management?
Analgesia
Supportive underwear
Reduce physical activity
Abstain from intercourse
What are ofloxacin, levefloxacin examples of ?
quinolones
What are 2 critical side effects of quinolone?
Tendon damage and rupture, notably in Achilles tendon
Lower seizure threshold
What are complications of epididymo-orchitis?
Chronic pain
Chronic epididymitis
Testicular atrophy
Sub-fertility or infertility
Scrotal abscess
