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]

Find information quickly and easily with a format that includes clearly presented algorithms, tables, and figures. Effectively review for the boards using the self-assessment questions at the end of each chapter. [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]

  [Campbell’s] Patients may present with pain, erythema and swelling in the groin region with or without a palpable cord, fever and inguinal lymphadenopathy. Chyluria may occur due to fistula development between lymphatics and the urinary tract. [ispub.com]

• 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]

  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 both cases, the chief complaints were high fever and painful scrotal swelling. [ci.nii.ac.jp]

  Swelling and redness over the affected scrotum Enlarged lymph nodes in the inguinal area Fever, mild to moderate Discharge from the penis, may be with urine. Sometimes, blood may be seen in semen. [buddymd.com]

• Gangrene

  Fournier gangrene is a type of necrotizing fasciitis or gangrene affecting the external genitalia and/or perineum. It commonly occurs in older men, but it can also occur in women and children. [en.wikipedia.org]

  Fournier gangrene ( necrotizing fasciitis ) is a gangrenous process that involves the external genitalia. It often arises from an infection involving the urinary tract or from direct extension from a perirectal source. See image below. [emedicine.medscape.com]

  These ultrasound and X-ray images of Fournier gangrene are courtesy of Ravi Kadasne, MD, UAE. References: Radiology article on Fournier gangrene of scrotum [ultrasound-images.com]

  Fournier's gangrene of the scrotum. Infectious conditions within the scrotal wall are also classified under the acute scrotum and include cellulitis and fasciitis (gangrene). [auanet.org]

  […] tunica vaginalis Boil of vas deferens Carbuncle of scrotum Carbuncle of spermatic cord Carbuncle of tunica vaginalis Carbuncle of vas deferens Cellulitis of scrotum Cellulitis of spermatic cord Cellulitis of tunica vaginalis Cellulitis of vas deferens Gangrene [icd9data.com]

• 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]

• Inguinal Pain

  The abnormal position of the inguinal testis also puts it at risk for trauma. The possible positioning of the testis in the inguinal canal should be kept in mind when a young boy presents with abdominal or inguinal pain following trauma to the area. [ispub.com]

• Fatigue

  A lack of testosterone in men can cause problems like erectile dysfunction, reduced sex drive, infertility, osteoporosis, increased breast tissue, decreased body and beard hair, depression, fatigue, and hot flashes. [beaumont.org]

• 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]

  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]

  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]

• 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]

  […] type of testicular torsion. spermatic cords and testicles twist. limits vascular flow and drainage, which results in ischemia. surgical treatment within 4-6 hours is necessary. peak incidence in neonates. symptoms: sudden onset of extreme pain, nausea, vomiting [quizlet.com]

• Abdominal Pain

  Pain is present in 20-30%. May have back or flank pain, dyspnoea, supraclavicular lymphadenopathy, abdominal mass (enlarged para-aortic lymph nodes), weight loss, gynaecomastia, epididymo-orchitis, or hydrocele. [patient.info]

  Case No 2 A 4-year-old male complained of lower abdominal pain, fever and swelling of the left scrotal sac of two days duration. [casesjournal.biomedcentral.com]

  associated with prostatitis. sexually transmitted organisms can cause this. slight fever, chills, sensation of heaviness, testicular sensitivity, enlargement of testicle, abdominal/pelvic pain, discharge, burning sensation, blood in urine. can be acute [quizlet.com]

  […] possibly associated with abdominal pain and fever. [ispub.com]

  abdominal 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]

• Fracture

  Scrotal and epididymal hematomas, epididymal fracture and rupture, and traumatic epididymitis can also occur. [criticalultrasoundjournal.springeropen.com]

  Identification of a fracture line through the testis is uncommon, but manifests as an avascular linear or curvilinear hypoechoic defect on US (Figure 15). The presence of a fracture line does not necessarily imply rupture of the testis. [appliedradiology.com]

• 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]

  Therefore, scrotal ultrasound has emerged to play a pivotal role in the evaluation of the patient presenting with acute scrotal pain. [criticalultrasoundjournal.springeropen.com]

  In both cases, the chief complaints were high fever and painful scrotal swelling. [ncbi.nlm.nih.gov]

  * Scrotal pain and swelling: The epididymis swells to often twice normal size within 3-4 hours (the degree of swelling is variable). * Pain on urination * Discharge from your urethra (at the end of your penis; especially in men younger than 35 years [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

  Testicular pain Many testicular and scrotal conditions can cause testicular pain. Other conditions, like kidney and ureteral stones, infections, and inguinal hernias can also cause pain that can be felt in or around the testicles and scrotum. [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]

  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]

  Diagnostic Considerations Men who have acute epididymitis typically have unilateral testicular pain and tenderness, hydrocele, and palpable swelling of the epididymis. [cdc.gov]

• Scrotal Mass

  A scrotal mass is an abnormal bulge or lump inside your scrotum. The scrotum is a sac of skin that contains your testicles. A scrotal mass can be a swollen testicle or it can contain fluid or other tissue. [healthline.com]

  History Part 3: Competing diagnoses that can mimic scrotal/testicular nodules or masses. A focal scrotal abscess can feel like a scrotal mass. [clinicaladvisor.com]

  Therefore, scrotal ultrasound is the imaging technique of choice to determine the nature of the scrotal mass and also to detect presence of scrotal abscesses. Although initial treatment is medical, it is sometimes necessary to resort to orchiectomy. [pesquisa.bvsalud.org]

  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]

• 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]

  Ajay Garg, MD. fournier gangrene of scrotum This two-year-old male baby had scrotal swelling. [ultrasound-images.com]

  A scrotal hematoma will appear as a discoloration and swelling of the scrotum usually following trauma. [ispub.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]

• Pelvic Pain

  The perineum may be easily overlooked during imaging examinations, but it can potentially contain numerous acute conditions in patients presenting with pelvic pain. [appliedradiology.com]

  associated with prostatitis. sexually transmitted organisms can cause this. slight fever, chills, sensation of heaviness, testicular sensitivity, enlargement of testicle, abdominal/pelvic pain, discharge, burning sensation, blood in urine. can be acute [quizlet.com]

  As the vas deferens extend from the seminal vesicles to the epididymes via the inguinal canal, infection can extend into the peritoneum and be a cause of pelvic pain or referred pain to the scrotum. [criticalultrasoundjournal.springeropen.com]

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]

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]

Although initial treatment is medical, it is sometimes necessary to resort to orchiectomy. This purpose of this paper is to propose inguinal approach for the surgical treatment of testicular abscesses. [pesquisa.bvsalud.org]

Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided. [ingentaconnect.com]

Extrapulmonary forms of nocardiosis must be recognized so that appropriate treatment can be instituted prior to dissemination. [ncbi.nlm.nih.gov]

If the masses in your scrotum are caused by cancer, you should see a cancer treatment specialist to evaluate whether or not you’re a good candidate for treatment. [healthline.com]

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]

Prognosis and Patient Counseling. Prognosis is highly dependent on pathology and staging of radical orchiectomy specimen. [clinicaladvisor.com]

[…] tumors. most common type of testicular neoplasm. constitute 40-50% of primary testicular tumors. usually in men between 35-39. most common malignant disease associated with undescended testicles. not very aggressive and radiosensitive. has the best prognosis [quizlet.com]

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]

Urinalysis, urine culture and complete blood count help to differentiate infectious etiologies from non-infectious etiologies. Furthermore, in the case of infectious etiologies, urine culture results guide antimicrobrial selection. [clinicaladvisor.com]

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]

Differentiating those etiologies that require immediate surgical intervention form those that can be treated medically is often challenging. [ispub.com]

The etiology of superficial scrotal abscess is infected hair follicles and infections of scrotal lacerations or minor scrotal surgeries. [emedicine.medscape.com]

Acute scrotal conditions due to traumatic, infectious, vascular, or neoplastic etiologies can all present with pain as the initial complaint. [criticalultrasoundjournal.springeropen.com]

"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]

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]

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]

Sandlow, Varicocele: current concepts in pathophysiology, diagnosis, and treatment. Urol Clin North Am, 2002. 29(4): p. 921-37. 10. Dreyer, G., et al., Pathogenesis of lymphatic disease in bancroftian filariasis: a clinical perspective. [ispub.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]

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]

The scrotal wound is left open and packed to prevent reoccurrence of the abscess. [emedicine.medscape.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]

How are epididymitis and orchitis prevented? No known method of preventing epididymitis or orchritis exist. [my.clevelandclinic.org]