Orchitis - Revision history

Rossdonaldson1: /* Management */

2023-08-17T20:45:47Z

Management

← Older revision		Revision as of 20:45, 17 August 2023
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	**>35yo, NO history of anal intercourse and NOT sexually active:		**>35yo, NO history of anal intercourse and NOT sexually active:
	***Ofloxacin 300mg PO BID x14 days '''OR''' [[levofloxacin]] 500mg QD x10 days '''OR''' [[ciprofloxacin]] 500mg PO BID x14 days		***Ofloxacin 300mg PO BID x14 days '''OR''' [[levofloxacin]] 500mg QD x10 days '''OR''' [[ciprofloxacin]] 500mg PO BID x14 days
	***IV: [[piperacillin/~~taxobactam~~]] 3.375g IV q6 or [[ampicillin/sulbactam]] 3g IV q6		***IV: [[piperacillin/tazobactam]] 3.375g IV q6 or [[ampicillin/sulbactam]] 3g IV q6

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2023-08-17T20:44:55Z

Management

← Older revision		Revision as of 20:44, 17 August 2023
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	***[[Doxycycline]] 100mg PO BID x14 days '''OR''' [[Azithromycin]] 1gm x1		***[[Doxycycline]] 100mg PO BID x14 days '''OR''' [[Azithromycin]] 1gm x1
	***Also treat sexual partner		***Also treat sexual partner
	**>35yo, history of anal intercourse ~~or non-~~sexually active:		**>35yo, NO history of anal intercourse and NOT sexually active:
	***Ofloxacin 300mg PO BID x14 days '''OR''' [[levofloxacin]] 500mg QD x10 days '''OR''' [[ciprofloxacin]] 500mg PO BID x14 days		***Ofloxacin 300mg PO BID x14 days '''OR''' [[levofloxacin]] 500mg QD x10 days '''OR''' [[ciprofloxacin]] 500mg PO BID x14 days
	***IV: [[piperacillin/taxobactam]] 3.375g IV q6 or [[ampicillin/sulbactam]] 3g IV q6		***IV: [[piperacillin/taxobactam]] 3.375g IV q6 or [[ampicillin/sulbactam]] 3g IV q6

Rossdonaldson1: /* Evaluation */

2020-11-11T22:50:43Z

Evaluation

← Older revision		Revision as of 22:50, 11 November 2020
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	==Evaluation==		==Evaluation==
			[[File:Ultrasonography of epididymitis.jpg\|thumb\|Doppler ultrasound of epididymitis, seen as a substantial increase in blood flow in the left epididymis (top image), while it is normal in the right (bottom image). The thickness of the epididymis (between yellow crosses) is only slightly increased.]]
	===Work-Up===		===Work-Up===
	*Testicular ultrasound		*Testicular ultrasound

Rossdonaldson1: /* Background */

2020-11-11T22:50:13Z

Background

← Older revision		Revision as of 22:50, 11 November 2020
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	==Background==		==Background==
			[[File:Gray1144.png\|thumb\|Scrotal anatomy]]
			[[File:Epididymis-KDS.jpg\|thumb\|Adult testicle with epididymis (left is posterior): A. Head of epididymis, B. Body of epididymis, C. Tail of epididymis, and D. Vas deferens.]]
	*Inflammation of testis - can be infectious (usually) or non-infectious		*Inflammation of testis - can be infectious (usually) or non-infectious
	*Infectious		*Infectious

ClaireLewis at 03:56, 24 September 2019

2019-09-24T03:56:14Z

← Older revision		Revision as of 03:56, 24 September 2019
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	*Inflammation of testis - can be infectious (usually) or non-infectious		*Inflammation of testis - can be infectious (usually) or non-infectious
	*Infectious		*Infectious
	**Viral - most common etiology is mumps (orchitis seen in 20-30% of mumps patients)<ref name="Trojian">Trojian, Thomas H., Timothy S. Lishnak, and Diana Heiman. "Epididymitis and orchitis: an overview." Am Fam Physician 79.7 (2009): 583-587.</ref>		**[[Viral syndrome\|Viral]] - most common etiology is [[mumps]] (orchitis seen in 20-30% of mumps patients)<ref name="Trojian">Trojian, Thomas H., Timothy S. Lishnak, and Diana Heiman. "Epididymitis and orchitis: an overview." Am Fam Physician 79.7 (2009): 583-587.</ref>
	***Epididymis typically not involved		***Epididymis typically not involved
	**Bacterial - typically due to hematogenous spread from [[Epididymitis\|epididymis]]: "epididymo-orchitis"		**Bacterial - typically due to hematogenous spread from [[Epididymitis\|epididymis]]: "epididymo-orchitis"
	***(bacterial infections rarely involve only the testis)		***(bacterial infections rarely involve only the testis)
	***bacterial pathogens: ''N. gonorrhea, C. trachomatis, E. Coli, Klebsiella, P. aeruginosa''		***bacterial pathogens: ''[[N. gonorrhea]], [[C. trachomatis]], [[E. Coli]], [[Klebsiella]], [[P. aeruginosa]]''

	==Clinical Features==		==Clinical Features==
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	**Abrupt onset of scrotal pain/swelling 4-7 days after onset of parotitis<ref name="Trojian" />		**Abrupt onset of scrotal pain/swelling 4-7 days after onset of parotitis<ref name="Trojian" />
	**Usually unilateral		**Usually unilateral
	*Fever, tachycardia		*[[Fever]], [[tachycardia]]
	*Inguinal lymphadenopathy		*Inguinal [[lymphadenopathy]]
	*Patient uncomfortable while seated		*Patient uncomfortable while seated

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	===Evaluation===		===Evaluation===
	*Combination of clinical features and results of imaging/UA		*Combination of clinical features and results of imaging/UA
	*~~Ultraound~~ may show inflammation, epididymitis, and rules out active torsion		*[[Testicular ultrasound\|Ultrasound]] may show inflammation, epididymitis, and rules out active torsion
	*[[Urinalysis]] positive for infection in epididymo-orchitis		*[[Urinalysis]] positive for infection in epididymo-orchitis

	==Management==		==Management==
	*Viral orchitis (mumps): supportive care, cold packs, scrotal elevation, analgesia.		*Viral orchitis (mumps): supportive care, cold packs, scrotal elevation, [[analgesia]].
	*Bacterial orchitis (epididymo-orchitis):		*Bacterial orchitis (epididymo-orchitis):
	**<35yo (assume sexually transmitted):		**<35yo (assume sexually transmitted):

Rossdonaldson1: Text replacement - "Urinalysis" to "Urinalysis"

2018-10-21T00:33:59Z

Text replacement - "*Urinalysis" to "*Urinalysis"

← Older revision		Revision as of 00:33, 21 October 2018
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	===Work-Up===		===Work-Up===
	*Testicular ultrasound		*Testicular ultrasound
	*Urinalysis and urine culture		*[[Urinalysis]] and urine culture
	*May also consider GC, Chlamydia cultures		*May also consider GC, Chlamydia cultures

Rossdonaldson1: Text replacement - "[[Ceftriaxone]]" to "Ceftriaxone"

2017-03-12T06:14:15Z

Text replacement - "[[Ceftriaxone]]" to "Ceftriaxone"

← Older revision		Revision as of 06:14, 12 March 2017
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	*Bacterial orchitis (epididymo-orchitis):		*Bacterial orchitis (epididymo-orchitis):
	**<35yo (assume sexually transmitted):		**<35yo (assume sexually transmitted):
	***[[[[Ceftriaxone]]]] 250mg IM x1 '''AND'''		***[[Ceftriaxone]] 250mg IM x1 '''AND'''
	***[[Doxycycline]] 100mg PO BID x14 days '''OR''' [[Azithromycin]] 1gm x1		***[[Doxycycline]] 100mg PO BID x14 days '''OR''' [[Azithromycin]] 1gm x1
	***Also treat sexual partner		***Also treat sexual partner

Ostermayer: Text replacement - "Ceftriaxone" to "Ceftriaxone"

2017-01-27T20:43:10Z

Text replacement - "Ceftriaxone" to "Ceftriaxone"

← Older revision		Revision as of 20:43, 27 January 2017
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	*Bacterial orchitis (epididymo-orchitis):		*Bacterial orchitis (epididymo-orchitis):
	**<35yo (assume sexually transmitted):		**<35yo (assume sexually transmitted):
	***[[Ceftriaxone]] 250mg IM x1 '''AND'''		***[[[[Ceftriaxone]]]] 250mg IM x1 '''AND'''
	***[[Doxycycline]] 100mg PO BID x14 days '''OR''' [[Azithromycin]] 1gm x1		***[[Doxycycline]] 100mg PO BID x14 days '''OR''' [[Azithromycin]] 1gm x1
	***Also treat sexual partner		***Also treat sexual partner

Rossdonaldson1: Text replacement - "UA" to "Urinalysis"

2016-10-02T17:51:31Z

Text replacement - "*UA" to "*Urinalysis"

← Older revision		Revision as of 17:51, 2 October 2016
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	*Combination of clinical features and results of imaging/UA		*Combination of clinical features and results of imaging/UA
	*Ultraound may show inflammation, epididymitis, and rules out active torsion		*Ultraound may show inflammation, epididymitis, and rules out active torsion
	*UA positive for infection in epididymo-orchitis		*[[Urinalysis]] positive for infection in epididymo-orchitis

	==Management==		==Management==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-24T18:46:00Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 18:46, 24 July 2016
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	{{Testicular DDX}}		{{Testicular DDX}}

	==~~Diagnosis~~==		==Evaluation==
	===Work-Up===		===Work-Up===
	*Testicular ultrasound		*Testicular ultrasound

Orchitis - Revision history

Rossdonaldson1: /* Management */

Rossdonaldson1: /* Management */

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Background */

ClaireLewis at 03:56, 24 September 2019

Rossdonaldson1: Text replacement - "*Urinalysis" to "*Urinalysis"

Rossdonaldson1: Text replacement - "[[Ceftriaxone]]" to "Ceftriaxone"

Ostermayer: Text replacement - "Ceftriaxone" to "Ceftriaxone"

Rossdonaldson1: Text replacement - "*UA" to "*Urinalysis"

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

Rossdonaldson1: Text replacement - "Urinalysis" to "Urinalysis"

Rossdonaldson1: Text replacement - "UA" to "Urinalysis"