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Epididymitis and Orchitis (Children)
⚠️ Always exclude testicular torsion as a differential. If in doubt → urgent surgical referral. 🚑
🦠 Causes
- 👉 Epididymitis:
- 🧫 Bacterial (UTI organisms: E. coli, Klebsiella, Proteus).
- 🦠 STIs in young men (Chlamydia, Gonorrhea).
- ↩️ Urinary reflux into vas deferens (e.g., posterior urethral valves).
- 💥 Trauma to the scrotum.
- 👉 Orchitis:
- 🦠 Viral (mumps — especially post-pubertal boys).
- 🧫 Bacterial (often secondary to epididymitis or STI-related).
🤒 Clinical Features
- 👉 Epididymitis:
- Gradual onset of scrotal pain & swelling.
- Red, warm, tender epididymis (pain may radiate to groin/abdomen).
- ± Fever, dysuria if UTI-related.
- 👉 Orchitis:
- Sudden painful swollen testis.
- Tenderness, erythema, systemic symptoms (fever, malaise).
- Often follows mumps infection → can cause epididymo-orchitis.
🔬 Investigations
- 👉 Epididymitis:
- Urinalysis & culture (look for leukocytes, nitrites).
- STI screen in adolescents/young men.
- Scrotal US: enlarged epididymis, ↑ blood flow.
- Bloods: CBC (↑ WCC).
- 👉 Orchitis:
- Scrotal US: exclude torsion, assess abscess.
- Urine/STI tests if bacterial suspected.
- Mumps IgM serology if viral cause suspected.
💊 Management
- 👉 Epididymitis:
- Empirical antibiotics (e.g., ceftriaxone + doxycycline for STI; co-amoxiclav/ciprofloxacin if UTI).
- NSAIDs, scrotal elevation, bed rest.
- Hydration; surgery only if abscess.
- 👉 Orchitis:
- Supportive care (NSAIDs, scrotal support, ice packs).
- If bacterial → antibiotics as above.
- Mumps orchitis → supportive only (no antivirals).
- Follow-up: monitor for testicular atrophy or abscess.
📌 Key exam tip: Epididymitis = gradual onset, often UTI/STI. Orchitis = sudden onset, often viral (mumps). Always rule out torsion. 🚨
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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