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Highlights & Basics
- Acute epididymitis is inflammation of the epididymis causing pain and swelling that develops over the course of a few days and is usually unilateral.
- Most commonly caused by bacterial infection, including Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium in sexually active men and uropathogens in older men.
- Testicular torsion is the most important differential diagnosis; if testicular torsion cannot be confidently excluded, urgent surgical exploration may be required.
- Diagnostic tests include Gram stain of urethral secretions, urine microscopy and culture, and urine specimens for nucleic acid amplification tests for C trachomatis, N gonorrhoeae, and M genitalium.
- All patients receive supportive treatment (including bed rest, scrotal elevation, and analgesia); further treatment depends on the likely cause, including prompt empiric antibiotic therapy in bacterial epididymitis.
Quick Reference
History & Exam
Key Factors
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Definition
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Citations
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American College of Radiology. ACR appropriateness criteria: acute onset of scrotal pain-without trauma, without antecedent mass. 2024 [internet publication].[Full Text]
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