Acute epididymo-orchitis

• Autores: Emma J. Street, Janet D. Wilson
• Localización: Medicine, ISSN-e 1357-3039, Vol. 41, Nº. 6, 2016, págs. 338-340
• Idioma: inglés
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• Resumen

  • Acute epididymo-orchitis is a clinical syndrome consisting of pain, swelling and inflammation of the epididymis that can extend into the testis. It is primarily caused by local extension of infection either from the urethra or the bladder. In men aged under 35 years, it is mostly caused by sexually transmitted infections (STIs), especially Chlamydia trachomatis or Neisseria gonorrhoeae. In men aged over 35 years, STIs can occur but acute epididymo-orchitis is more commonly a complication of a urinary tract infection. Mumps has become an important alternative aetiology of epididymo-orchitis following the recent epidemic in non-immune adults in 2005/2006. The main and most important differential diagnosis is torsion of the spermatic cord.

    Epididymo-orchitis typically presents with subacute onset of unilateral scrotal pain and swelling. Investigations are required for C. trachomatis, N. gonorrhoeae, and urinary tract infections. Management involves scrotal support and non-steroidal anti-inflammatory drugs (NSAIDs). Empirical antibiotics are chosen on the basis of sexual history, near-patient tests if available, urological past history and age.