Acute epididymitis

Acute epididymitis is inflammation of the epididymis causing pain and swelling that develops over the course of a few days and is usually unilateral.

Most commonly caused by bacterial infection, including Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium in sexually active men and uropathogens in older men.

Testicular torsion is the most important differential diagnosis; if testicular torsion cannot be confidently excluded, urgent surgical exploration may be required.

Diagnostic tests include Gram stain of urethral secretions, urine microscopy and culture, and urine specimens for nucleic acid amplification tests for C trachomatis, N gonorrhoeae, and M genitalium.

All patients receive supportive treatment (including bed rest, scrotal elevation, and analgesia); further treatment depends on the likely cause, including prompt empiric antibiotic therapy in bacterial epididymitis.

Acute epididymitis is inflammation of the epididymis characterized by scrotal pain and swelling of less than 6 weeks' duration.[1]Taylor SN. Epididymitis. Clin Infect Dis. 2015 Dec 15;61 Suppl 8:S770-3. https://pubmed.ncbi.nlm.nih.gov/26602616 http://www.ncbi.nlm.nih.gov/pubmed/26602616?tool=bestpractice.com It may be associated with irritative lower urinary tract symptoms, urethral discharge, and fever. It is usually unilateral. The condition is referred to as acute epididymo-orchitis if concurrent inflammation of the testis is present.