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Clinic Infections - Urithristis
35 y/o M with L testicular swelling and pain with +ive Chlamydia urethral swab - Dx?
Important DDx for testicular swelling to consider?
Other less pressing DDx to consider for testicular swelling?
Incarcerated hernia, testicular tumor (w inflammatory reaction), rarely - amiodarone rxn, TB, vasculitis
Usual presentation of testicular torsion
Younger males/teens and sudden onset
3 most common pathogens causing epididimo-orchitis?
1) Chlamydia 2) Gonorrhea 3) E Coli (2º to prostatitis, M>35)
Most common orchitis pathogen in older men?
E Coli - 2º to prostatitis
What should be ordered in all men with epididimo-orchitis?
STI testing, Urine culture
How do you treat epididimo-orchitis with +ive Chlamydia test?
- DON'T TREAT AS SIMPLE CHLAMYDIA INFECTION! THIS IS A COMPLICATED STI
- Doxycycline 100mg PO BID x 10-14days, Ceftriaxone 250mg IM x 1
If the patient were 55, not had previous Chlamydia result - how would you treat their epididimo-orchitis?
- Treat them for UTI/bacterial prostatitis - 2 week duration for men.
- i.e. Ciprofloxacin 500mg PO BID x 2 weeks
What would you like to do?
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