questions 2

Epididymitis

Author:
Topic updated on 03/28/17 8:26pm

Snapshot
  • epididymitisA 28-year-old male presents with pain and tenderness of his right testicle. These symptoms started gradually over the last day. On physical exam, his pain is lessened with elevation of the effected testicle. An ultrasound of his testicle is given.
Introduction
  • An infection of the epididymis 
  • Pathogen varies by patient age
    • < 35 years old
      • N. gonorrhoeae, C. trachomatis
    • > 35 years old
      • E. coli, P. aeruginosa
  • Also associated with
    • systemic MTB
      • caseating granulomas seen histologically
    • AIDS
      • results in CVM, Toxoplasma, Salmonella infections
  • Must be distinguished from testicular torsion
    •  
Presentation
  • Symptoms
    • unilateral pain in scrotum
      • may radiate to flank
  • Physical exam
    • scrotal swelling, tenderness, and erythema
    • testicle is not elevated in the scrotum
      • seen in testicular torsion
    • Prehn's sign
      • decrease in pain with scrotal elevation
      • negative in testicular torsion
Treatment
  • Medical
    • ciprofloxacin or levofloxacin
      • if greater than 35 years old
      • can use if <14, cause is enteric, and if no other effective alternative (i.e. trimethoprim-sulfamethoxazole or cephalexin)
    • doxycycline + ceftriaxone 
      • empiric treatment for N. gonorrheae and C. trachomatis
      • if between 14 to 35 years old


  RATE CONTENT
5.0
AVERAGE 5.0 of 1 RATINGS

Qbank (1 Questions)

TAG
(M2.RL.82) A 68-year-old male presents with pain and tenderness of his right testicle. These symptoms started gradually over the last day. Vital signs are as follows: T 99.8 F, HR 75, BP 125/80 mmHg, RR 12. On physical exam, he has severe pain when the testicle is palpated which is lessened with elevation of the involved testicle. Doppler ultrasound shows normal blood flow in both testes. Which of the following organisms is the most likely pathogen in this patient's condition? Topic Review Topic

1. N. gonorrhoeae
2. C. trachomatis
3. E. coli
4. S. aureus
5. S. epidermidis

PREFERRED RESPONSE ▶
Sorry, this question is only available for Study Plan members.
Access to 600+ Questions not available in Free Qbank



Evidence & References Show References




Topic Comments

Subscribe status: