Orchitis and epididymitis
•
Orchitis
is an uncommon condition in boys that presents with fever and testicular pain.
•
Approximately
20% of prepubertal patients with mumps develop orchitis.
•
Diagnosis
based on a history of recent mumps or parotitis; mumps orchitis is unilateral
in 70% of cases.
•
In 30%
of cases, contralateral testicular involvement follows a few days later.
•
This
condition is rare in post-pubertal boys.
•
Bacterial
orchitis is usually associated with an epididymitis.
•
Usually
associated with concomitant orchitis.
•
In
children epididymo-orchitis is usually associated with a urinary tract
infection: infected urine refluxes down the vas.
•
Structural
abnormality in the renal tract should be excluded.
•
Epididymo-orchitis
presents with fever, urinary symptoms, and scrotal pain.
•
In
sexually-active adolescents epididymo-orchitis may be caused by gonorrhoea or Chlamydia.
•
Epididymo-orchitis
should be managed with antibiotics once urine has been sent for culture.
Adolescents should be screened for sexually transmitted infection.
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