Epididymo-orchitis

Epididymo-orchitis is a clinical syndrome consisting of pain , swelling and inflammation of the epididymis with or without inflammation of the testisEpididymitis and Orchitis -respective definitions Acute epididymitis → inflammation of the epididymis characterized by scrotal pain and swelling of < 6 wks and Orchitis → acute inflammatory reaction of the testis secondary to infection

Main differential is torsion of the spermatic cord Epididymitis is the most common cause of scrotal pain in adults Patients with testicular torsion present usually earlier than those with epididymitis Epididymitis can be acute and chronic ( > 3 months ) Isolated orchitis is rare ( commonest cause is mumps )

STI eg unprotected or anal intercourse H/O Mumps or contact with TB Instrumentation and indwelling catheters structural or functional abnormality of the urinary tract Systemic illness and immunosuppression

Causes -Chlamydia trachomatis N gonorrhoeae M genitalum Gram negative enteric organisms Gram negative enteric organisms eg E Colieg obstructive urinary disease , urinary tract surgery or instrumentation Mumps can cause epididymo-orchitis at any age Amiodarone - symptoms improve when Rx stopped ( high drug conc in usually in head of epididymis ) Vasculitis- rare cases reported with Bechet's and Henosch Schonlein purpura Idiopathic Polyarteritis nodosa

Onset...