Epididymitis acuta - Altmeyers Encyclopedia

Synonym(s)

Acute epididymitis; Epididymitis

Definition
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Mostly an infection of the epididymis, usually followed by urethritis, often in gonorrhoea.

Pathogen
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Mainly Neisseria gonorrhoeae or Chlamydia trachomatis.

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Clinical features
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Sudden, severe pain in the testicles, fever. Mostly unilateral, pressure-painful enlargement of the epididymis, highly red, shiny skin.

Laboratory
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Leukocytosis, urine sediment: leukocytes, bacteria, elevated non-specific inflammation markers (CRP).

Differential diagnosis
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Testicular torsion, testicular tumors, hydrocele, varicocele, dermatocele.

General therapy
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Cooperation with the urologist. Bed rest for a few days, testicular elevation with a testicular bench or elevation of the testicles with a wide plaster band (attached to both thighs). Moist compresses with physiological saline solution, cooling.

Internal therapy
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Immediate, high-dose antibiotic administration with cephalosporins such as ceftriaxone (Rocephin) 250-500 mg i.v. combined with doxycycline (e.g. Doxy-Wolff) 2 times/day 100 mg p.o. for at least 8-10 days
Alternatively broad-spectrum antibiotics ( gyrase inhibitors) such as Ofloxacin (Tarivid) 2 times/day 300 mg p.o. for at least 8-10 days.
Alternatively penicillin 10 mega/day i.v. (e.g. penicillin Grünenthal) combined with tetracyclines (e.g. Achromycin Filmtbl.) 4 times/day 250 mg.