Edit concept Question Editor Create issue ticket

Testicular Abscess

Testis Abscess


Presentation

  • OBJECTIVE: To report relatively uncommon presentations of epididymo-orchitis and testicular abscess caused by Salmonella spp. in 2 immunocompromised patients.[ncbi.nlm.nih.gov]
  • We present the sixth case of epididymo-orchitis attributable to this organism. A 78-year-old man presented to the Mayo Clinic with fever and weight loss after being treated with cyclophosphamide and prednisone for an immune-mediated vasculitis.[ncbi.nlm.nih.gov]
  • The clinical spectrum of presentation of Salmonella infection has widened as increasing reports are being published about the unusual forms of presentation.[cjhr.org]
  • In most cases epididymo-orchitis has been present for some time, and thus typically patients present with testicular pain, often accompanied by fever and swelling, which have lasted a number of days.[radiopaedia.org]
  • Presents a section devoted to clinical scenarios-organized by presenting signs or disease processes-covering those you're most likely to encounter in daily practice.[books.google.com]
Inguinal Lymphadenopathy
  • Inguinal lymphadenopathy may be present (due to metastases or infection). Testicular cancer may present as a painless testicular swelling, and is often curable if treated early.[patient.info]
Fever
  • A 78-year-old man presented to the Mayo Clinic with fever and weight loss after being treated with cyclophosphamide and prednisone for an immune-mediated vasculitis. He was found to have a testicular abscess, and orchiectomy was performed.[ncbi.nlm.nih.gov]
  • In both cases, the chief complaints were high fever and painful scrotal swelling.[ncbi.nlm.nih.gov]
  • He had fever, arthralgia and his right epididymis and right testicle were enlarged and tender. Ultrasound evaluation showed hypertrophy of the right epididymis and testis and moreover hypoechoic area within the testis.[ingentaconnect.com]
  • In most cases epididymo-orchitis has been present for some time, and thus typically patients present with testicular pain, often accompanied by fever and swelling, which have lasted a number of days.[radiopaedia.org]
High Fever
  • In both cases, the chief complaints were high fever and painful scrotal swelling.[ncbi.nlm.nih.gov]
  • Because high fever is uncommon and indicates a complicated infection, hospitalization for further evaluation is recommended.[cdc.gov]
Nausea
  • The symptoms of epididymitis may include pain (from mild to severe), swelling of the testicles or scrotum, nausea and vomiting, and fever. Hydrocele Hydrocele is a buildup of fluid around the testicles.[beaumont.org]
  • Fever, nausea Discharge from the penis Ache in the groin region, especially while urination or voiding. Treatment Rest is advised. Inflammation is reduced by giving anti inflammatory drugs. Cold ice packs may be applied over the affected side.[buddymd.com]
  • Seek care immediately. * Urinary symptoms * Discharge from your penis * Pain or burning with urination * Urinary frequency (more often than normal) * Fever and chills * Nausea * Abdominal or flank pain Testicle Infection (Epididymitis) Exams and Tests[justanswer.com]
  • These are those with intractable pain; those with nausea or vomiting that inhibit oral medications; those with evidence of an abscess; those who fail to improve after 72 hours of outpatient treatment, and those who are immunocompromised with significant[my.clevelandclinic.org]
  • Discharge from the urethra (at the end of the penis; especially in men younger than 39 years of age) Fever and chills Nausea What Causes Epididymitis? The cause of epididymitis is usually a bacterial infection.[emedicinehealth.com]
Vomiting
  • This whole incident started with Muttley vomiting once soon after he had his morning meal. After vomiting he was quite restless for a few hours, couldn't find a single spot to lay down or a single comfortable position.[wagwalking.com]
  • The symptoms of epididymitis may include pain (from mild to severe), swelling of the testicles or scrotum, nausea and vomiting, and fever. Hydrocele Hydrocele is a buildup of fluid around the testicles.[beaumont.org]
  • Painful; usually severe pain, which may radiate to the abdomen; may have vomiting. Cremasteric reflex is almost always absent. Testis is often elevated or lying transversely. Neonates - testis is hard, non-tender, and usually haemorrhagic.[patient.info]
  • These are those with intractable pain; those with nausea or vomiting that inhibit oral medications; those with evidence of an abscess; those who fail to improve after 72 hours of outpatient treatment, and those who are immunocompromised with significant[my.clevelandclinic.org]
  • Recurrent pain is rare with epididymitis and torsion of the appendix testis (upper pole of testis), but can occur with testicular torsion (caused by intermittent torsion with spontaneous resolution). 16 The presence or absence of nausea and vomiting is[aafp.org]
Abdominal Pain
  • May be features of strangulation or obstruction (abdominal pain and/or intestinal obstruction symptoms). Cannot get above the swelling. Squamous cell carcinoma of the scrotum Extremely rare; usually only in men aged 50 years.[patient.info]
  • pain similar to a hernia (see referred pain ).[en.wikipedia.org]
Tachycardia
  • Patients with epididymitis and orchitis often have tachycardia or fever. Patients may also be uncomfortable while seated, but this is also common with testicular torsion.[aafp.org]
Scrotal Pain
  • General May mimic a testicular tumour. [1] Clinical: [2] Scrotal pain. Scrotal swelling. Microscopic Features: Abundant neutrophils . /-Microorganisms. DDx: Germ cell neoplasia in situ . Lymphoma of the testis. Necrotic germ cell tumour .[librepathology.org]
  • In both cases, fever and scrotal pain subsided after antibiotic chemotherapy, and inflammatory reactions on routine blood studies were normalized within 2 weeks.[ncbi.nlm.nih.gov]
  • If you have scrotal pain or urinary symptoms and cannot be seen by your health care provider (or if you do not have one), then you should go to a hospital’s emergency department.[justanswer.com]
  • Symptoms Scrotal pain Pain in the testicles Swelling of the testicles Redness in the scrotum area Pain during sexual intercourse Pain during urination Fever Chills Diagnosis During a general examination, the doctor will examine the patient’s testicles[bookinghealth.com]
Testicular Pain
  • In most cases epididymo-orchitis has been present for some time, and thus typically patients present with testicular pain, often accompanied by fever and swelling, which have lasted a number of days.[radiopaedia.org]
  • If you have testicular pain, you should contact your doctor right away. And if you experience a sudden onset of testicular pain, you should seek emergency medical care to rule out serious conditions like testicular torsion.[beaumont.org]
  • If it is left untreated, it could lead to chronic epididymo-orchitis, where persistent testicular inflammation leads to recurring testicular pain. It can also lead to testicular shrinkage or testicular abscess (pus collection within the testicle).[leedssexualhealth.com]
  • Chronic epididymitis refers to inflammation characterized by persistent testicular pain in the absence of scrotal swelling. This condition is usually more difficult to treat and may result in long-term pain.[innerbody.com]
  • Diagnostic Considerations Men who have acute epididymitis typically have unilateral testicular pain and tenderness, hydrocele, and palpable swelling of the epididymis.[cdc.gov]
Swelling of the Scrotum
  • It can affect one or both testicles, and it can cause swelling in the scrotum and groin area. Hydrocele is not usually painful or harmful, and it may not need treatment. However, any swelling in the scrotum should be evaluated by a doctor.[beaumont.org]
  • Diagnosis and Treatment In acute epididymitis, the physical examination shows tenderness and swelling of the scrotum, discharge from the penis, enlarged groin lymph nodes , and fever.[innerbody.com]
  • Typical findings are redness, warmth and swelling of the scrotum, with tenderness behind the testicle, away from the middle (this is the normal position of the epididymis relative to the testicle).[en.wikipedia.org]
Scrotal Mass
  • Scrotal mass in a neonate: Testicular abscess. Am J Dis Child 1975; 129 1361–1362. PubMed Google Scholar 6. McCartney ET, Stewart I. Suppurative orchitis due to Pseudomonas. J Paed 1958; 52: 451–453. CrossRef Google Scholar 7.[link.springer.com]
  • Anorchia (Medical Encyclopedia) Hydrocele (Medical Encyclopedia) Hydrocele repair (Medical Encyclopedia) Hypogonadotropic hypogonadism (Medical Encyclopedia) Orchitis (Medical Encyclopedia) Scrotal masses (Medical Encyclopedia) Testicle lump (Medical[icdlist.com]

Workup

  • Clinical signs may not be convincing, and a complete workup is necessary. This article highlights the role of microbiological investigation in identifying the causative organism and confirming the diagnosis.[cjhr.org]
Nocardia Asteroides
  • Abstract A case of a localized testicular abscess due to Nocardia asteroides in a patient on immunosuppressive therapy for a myeloproliferative disorder is reported.[ncbi.nlm.nih.gov]
  • Abstract Nocardia asteroides complex is a rare human pathogen chiefly affecting immunosuppressed patients. We present the sixth case of epididymo-orchitis attributable to this organism.[ncbi.nlm.nih.gov]

Treatment

  • Extrapulmonary forms of nocardiosis must be recognized so that appropriate treatment can be instituted prior to dissemination.[ncbi.nlm.nih.gov]
  • Treatment Conservative treatment, such as antibiotics, may be prescribed to fight the infection and prevent a future recurrence. Antibiotics need to be taken for a defined period of time if they are to be effective.[bookinghealth.com]
  • Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided.[ingentaconnect.com]
  • Stay abreast of new AUA and ICI Incontinence guidelines, and access up-to-date information on the latest treatment recommendations, therapy for castrate-resistant prostate cancer, and active surveillance for prostate cancer.[books.google.com]
  • Treatments include drainage and antibiotics.[icdlist.com]

Prognosis

  • Treatment and prognosis Management may include prolonged antibiotics, surgical debridement or even orchidectomy 1,4 .[radiopaedia.org]
  • […] requiring intravenous antibiotics and debridement (surgical removal) of necrotic (dead) tissue. [2] In addition to surgery and antibiotics, hyperbaric oxygen therapy may be useful and acts to inhibit the growth of and kill the anaerobic bacteria. [7] Prognosis[en.wikipedia.org]
  • If treated appropriately with antibiotics, epididymitis should be cured and the individual will have an excellent prognosis (outlook). The pain should improve within 1-3 days; however, swelling may take several days to resolve.[emedicinehealth.com]

Etiology

  • In patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome, fungal and viral etiologies, including cytomegalovirus, have been reported. 7 , 8 Noninfectious etiologies of epididymitis have been identified in numerous groups[aafp.org]
  • The etiology of superficial scrotal abscess is infected hair follicles and infections of scrotal lacerations or minor scrotal surgeries.[emedicine.medscape.com]
  • Other etiologic agents have been implicated in acute epididymitis in men with HIV infection, including CMV, salmonella, toxoplasmosis, Ureaplasma urealyticum , Corynebacterium sp., Mycoplasma sp., and Mima polymorpha .[cdc.gov]

Epidemiology

  • "Fournier's gangrene: Population based epidemiology and outcomes" . The Journal of Urology . 181 (5): 2120–6. doi : 10.1016/j.juro.2009.01.034 . PMC 3042351 . PMID 19286224 .[en.wikipedia.org]
  • […] epididymitis will eventually "burn out" of patient's system if left untreated, though this might take years or even decades. [5] However, some prostate -related medications have proven effective in treating chronic epididymitis, including doxazosin . [14] Epidemiology[en.wikipedia.org]
  • Epidemiology A study of UK general practices during the years 2003-2008 reported a highest incidence of 25/10,000 in 2004-2005. The incidence declined during the latter part of the study [ 11 ] .[patient.info]
  • C 12 Epidemiology In 2002, epididymitis or orchitis accounted for 1 in 144 outpatient visits (0.69 percent) in men 18 to 50 years of age. 1 There are approximately 600,000 cases of epididymitis per year in the United States, most of which occur in men[aafp.org]
  • Washington, DC American Society for Microbiology (pg. 382 - 6 ) 25 , Practical statistics for medical research , 1992 London Chapman and Hall 26 , Epi Info, version 6: a word processing, data base, and statistics program for epidemiology on micro-computers[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • Etiology and Pathophysiology Epididymitis is the most common cause of intrascrotal inflammation, 5 and retrograde ascent of pathogens is the usual route of infection.[aafp.org]

Prevention

  • Treatment Conservative treatment, such as antibiotics, may be prescribed to fight the infection and prevent a future recurrence. Antibiotics need to be taken for a defined period of time if they are to be effective.[bookinghealth.com]
  • Treatment of Acute Epididymitis The goals are to cure the infection, prevent transmission of the infection to others, and prevent infertility or chronic pain.[innerbody.com]
  • How are epididymitis and orchitis prevented? No known method of preventing epididymitis or orchritis exist.[my.clevelandclinic.org]
  • If you are treated for epididymo-orchitis, it is really important that your partner also gets treated before you have sex again to prevent reinfection.[leedssexualhealth.com]
  • Other prevention methods are as follows: abstinence (no sexual relations); condom use (reduces chances for infection by about 90%); monogamy with only one uninfected sex partner; preventing child abuse in pediatric patients; and mumps vaccination.[emedicinehealth.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!