Inflamation of the epididymis that is painful and acute usually STI in origin. Commonly caused by N. gonorrhoeae or C. trachomatis in the sexually active adolescent. Also has other bacterial and viral causes.
Scrotal edema and erythema noted. Epididymis is hard, indurated, enlarged, and tender. Spermatic cord is tender. Cremasteric reflex is normal.
PREHN's sign - elevation of the testes releives pain. (increases pain in torsion)
Urethral discharge purulent in gonorrhea maybe present, prostate tender on exam.
- TX - Bed rest, scrotal support and elevation. Apply ice packs, sitz baths and analgesics.
- ABX - first line - ceftriaxone IM plus doxycycline.
Treat sexual partners.