https://idwiki.org/index.php?action=history&feed=atom&title=Epididymo-orchitis 2026-04-16T17:15:25Z Revision history for this page on the wiki MediaWiki 1.43.6 https://idwiki.org/index.php?title=Epididymo-orchitis&diff=11720&oldid=prev 2026-04-15T18:23:57Z

<p>Created page with &quot;== Background == * Inflammation of the epididymis with or without inflammation in the testes * Historically thought to be caused mostly by STIs in patients under 35, and mostly by enteric pathogens in patients over 35, though this may be changing === Etiology === * Sexually-transmitted infection: <a href="/Chlamydia_trachomatis" title="Chlamydia trachomatis"><i>Chlamydia trachomatis</i></a>, <a href="/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae"><i>Neisseria gonorrhoeae</i></a>, <a href="/Mycoplasma_genitalium" title="Mycoplasma genitalium"><i>Mycoplasma genitalium</i></a>, and enteric bacteria (in patients who engage in insertive anal intercourse) * Non-sexually-tr...&quot;</p> <p><b>New page</b></p><div>== Background ==<br /> <br /> * Inflammation of the epididymis with or without inflammation in the testes<br /> * Historically thought to be caused mostly by STIs in patients under 35, and mostly by enteric pathogens in patients over 35, though this may be changing<br /> <br /> === Etiology ===<br /> <br /> * Sexually-transmitted infection: [[Chlamydia trachomatis]], [[Neisseria gonorrhoeae]], [[Mycoplasma genitalium]], and enteric bacteria (in patients who engage in insertive anal intercourse)<br /> * Non-sexually-transmitted: enteric organisms (typically [[Enterobacteriaceae]]), often with history of recurrent urinary tract infection or recent urological procedures<br /> * Rare causes:<br /> ** [[Mumps]] orchitis (without epididymitis)<br /> ** [[Tuberculosis]]<br /> ** [[Brucella]]<br /> ** [[Ureaplasma urealyticum]]<br /> ** [[Syphilis]] (case reports)<br /> ** [[Melioidosis]]<br /> ** [[Enterovirus]], particularly in children and young men<br /> ** [[Candida]]<br /> ** [[Behçet disease]]<br /> ** [[Amiodarone]] toxicity<br /> <br /> == Clinical Manifestations ==<br /> <br /> * Acute onset scrotal pain, typically unilateral, with or without swelling<br /> * Tenderness to palpation<br /> * May have urethral discharge or dysuria<br /> * May have fevers<br /> * May have hydrocele<br /> <br /> == Differential Diagnosis ==<br /> <br /> * [[Testicular torsion]], which is usually sudden onset and severe, and requires emergent surgery<br /> <br /> == Investigations ==<br /> <br /> * Urinalysis and midstream urine culture<br /> * Swab or urine for [[gonorrhea]], [[chlamydia]], [[Mycoplasma genitalium]]<br /> * Ultrasound of the testicles<br /> <br /> == Diagnosis ==<br /> <br /> * Clinical diagnosis<br /> <br /> == Management ==<br /> <br /> * Suspected sexually-transmitted pathogen:<br /> ** [[Ceftriaxone]] 1 g IM once, plus [[doxycycline]] 100 mg p.o. twice daily for 14 days<br /> * Either sexually-transmitted or enteric pathogen:<br /> ** [[Ceftriaxone]] 1 g IM once, plus [[levofloxacin]] 500 mg p.o. daily for 10 to 14 days<br /> * Suspected enteric pathogen alone:<br /> ** Levofloxacin 500 mg p.o. once daily for 10 to 14 days<br /> * Of note, [[levofloxacin]] preferred to [[ciprofloxacin]] due to better coverage for STIs<br /> <br /> == Further Reading ==<br /> <br /> * The 2024 European guideline on the management of epididymo-orchitis. &#039;&#039;J Eur Acad Dermatol Venereol&#039;&#039;. 2026;40(2):166-173. doi: [https://doi.org/10.1111/jdv.20865 10.1111/jdv.20865]. Epub 2025 Jul 23. PMID: [https://pubmed.ncbi.nlm.nih.gov/40698982/ 40698982].<br /> <br /> [[Category:Genitourinary infections]]<br /> [[Category:Sexually-transmitted infections]]</div>

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