Epidydimo-orchitis

Question 1

What causes epididymo orchitis most commonly >35 vs <35

Answer 1

<35 = STI - chlamydia or gonorrhea
>35 = bladder negative entero eg e coli, enterococcus faecalis

Question 2

Features of Epididymo-orchitis

Answer 2

Unilateral testicular pain and swelling
Urethral dsiacharge +/-

Question 3

Treatment Epididymo-orchitis if unknown orgnaism

Answer 3

Ceftriazone IM, doxy oral for 10-14 days

Oral quinolone is STI unlikely eg ofloxacin

Question 4

Other causes of epididymo orchitis rare

Answer 4

Mumps
TB
Behcets disease
Amiodarone - 3-11%

Question 5

Investiations for STI causing Epididymis orchitis

Answer 5

Urethral swab for gonorrhea and c. trichomalis (NAAT)
Gram staining

Question 6

Investigations epidiymo orchitis

Answer 6

Likely STI - urethral swab for chalmydia and gonorrhea (NAAT)
Low risk STI -> mid stream urine sample

US scan if uncertainty
IgG/IgM for mumps
TB 3 x AFFB

Question 7

Complications epidiymo orchitis

Answer 7

Reactive hydrocele.
Infertility
Rare - abscess formation and infarction of the testicle.
Mumps -> testicular atrophy, sub-fertility and infertility.