epididymo-orchitis

Question 1

causes of epididymo-orchitis

Answer 1

• e.coli
• chlamydia
• gonorrhoea
• mumps

Question 2

presentation of epididymo-orchitis

Answer 2

gradual onset over minutes to hours
- testicular pain
- dragging or heavy sensation
- swelling of testicle and epididymis
- tenderness on palpation (over epididymis
- urethral discharge
- systemic symptoms

Question 3

investigations for epididymo-orchitis

Answer 3

• urine microscopy, culture and sensitivity
• chlamydia and gonorrhoea NAAT testing
• charcoal swab of purulent urethral discharge for gonorrhoea
• saliva swab for PCR for mumps
• serum antibodies for mumps (IgM- acute, IgG- previous infection)
• USS- torsion or tumours

Question 4

management of epididymo-orchitis

Answer 4

admit to hospital
local antibiotics- quinolone

Question 5

quinolone antibiotics overview

Answer 5

ofloxacin, levofloxacin and ciprofloxacin- broad spectrum cover
used in: UTI, pyelonephritis, epididymo-orchitis and prostatitis
gram neg cover
side effects: tendon damage and rupture (achilles) and lower seizure threshold