Fact-sheet: Epididymitis
Updated on 04/19/2018 at 6:45 PM
View all RADEOS cases associated with this fact-sheet
Definition
-Inflammation of a testis (Orchitis) and an epididymis (epididymitis)
-Generally secondary to a urinary pathogen infection (E. coli most often), retrograde
-Possible context of sexually transmitted infection
-More rarely due to a systemic infection such as mumps Orchitis
Clinical features
-Scrotal pain
-Fever
-Local inflammatory signs
Laboratory findings
Biological infectious syndrome
Urinalysis with culture looks for leukocyturia and bacteriuria.
Blood cultures may be performed in cases of marked infectious syndrome
Ultrasound
-Enlarged testis, heterogeneous echostructure, hypervascularization on Doppler -Epididymal enlargement, epididymal hypervascularization -Associated signs: +/- Hydrocele, +/- scrotal wall thickening, pyocele 3 types of complications: -Septic (abscess, purulent liquefaction), -vascular (ischemic necrosis), -Long-term (secondary infertility)
CT
no indication
MRI
no indication
Management
Bed rest
Wearing a scrotal support or tight-fitting underwear to limit pain
Analgesic Nonsteroidal
anti-inflammatory drug
Antibiotic tailored to the causative organism
Differential diagnosis
Only one differential diagnosis: spermatic cord torsion --> surgical emergency!