Materiały źródłowe

• #1 Orchitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860

  Orchitis (or-KIE-tis) refers to infection or swelling and irritation, called inflammation, of one or both testicles. […] A number of conditions can cause testicle pain. Many go away on their own. But some need treatment right away. […] Your healthcare professional can do tests to find out which condition is causing your pain. […] Infection with a virus or bacteria can cause orchitis. Sometimes a cause can’t be found. […] Most often, bacterial orchitis is linked with or is the result of epididymitis. […] The mumps virus most often causes viral orchitis. […] For pain or swelling in your scrotum that comes on quickly, see your healthcare professional right away.

• #2 Orchitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001280.htm

  Orchitis is swelling (inflammation) of one or both of the testicles. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #3 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  Orchitis is the inflammation of the testis and is usually unilateral. […] Diagnosis is generally on history and physical examination. […] Accurate diagnosis is crucial for efficient management. […] Orchitis diagnosis is usually from history and physical findings. […] Laboratory tests are generally not helpful, but urethral swabs and urine samples may be obtained for routine examination and cultures to rule out urinary tract infection and diagnose sexually transmitted infections as the source. […] When assessing patients with acute testicular or scrotal pain, it is imperative to rule out testicular torsion. […] For such patients, color Doppler ultrasonography of the scrotum is the first choice of investigation. […] Although not typically done, serum immunofluorescence antibody testing is useful to confirm the diagnosis of mumps orchitis.

• #4 Orchitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/diagnosis-treatment/drc-20375865

  Your healthcare professional starts with your medical history and a physical exam. The exam checks for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. You also might have a rectal exam to check for prostate enlargement or tenderness. […] Tests might include: […] Ultrasound. This imaging test is to find the cause of testicular pain. Ultrasound with color Doppler can show if the blood flow to your testicles is lower than it should be. This could mean you have torsion. A higher than usual blood flow helps confirm the diagnosis of orchitis. […] For orchitis, questions might include: […] What tests do I need? […] Your healthcare professional is likely to ask you questions, including: […] What treatments have you tried? […] What, if anything, seems to ease your symptoms? […] What, if anything, appears to make your symptoms worse?

• #5 Orchitis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/777456-workup

  Epididymo-orchitis is a clinical diagnosis based on symptoms and signs. […] Diagnosing mumps orchitis can be comfortably made based on history and physical examination alone. Diagnosing mumps orchitis can be confirmed with serum immunofluorescence antibody testing. […] Obtaining a C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) may also be helpful, because elevations of these are more suggestive of inflammation associated with epididymo-orchitis. […] Color Doppler ultrasonography has become the imaging test of choice for the evaluation of acute testicular pain. […] Often, the history and physical examination are enough to make the diagnosis; however, as an adjunct, ultrasonography is highly sensitive for ruling out testicular torsion and for demonstrating inflammation of the testis or the epididymis.

• #6 Orchitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001280.htm

  Orchitis is swelling (inflammation) of one or both of the testicles. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #7 Orchitis – UF Health

  https://ufhealth.org/conditions-and-treatments/orchitis

  Orchitis is swelling (inflammation) of one or both of the testicles. […] Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition. […] The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis most often develops 4 to 6 days after the mumps begins. […] Orchitis may also occur along with infections of the prostate or epididymis. […] Orchitis may be caused by a sexually transmitted infection (STI), such as gonorrhea or chlamydia. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage.

• #8 Orchitis – UF Health

  https://ufhealth.org/conditions-and-treatments/orchitis

  Orchitis is swelling (inflammation) of one or both of the testicles. […] Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition. […] The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis most often develops 4 to 6 days after the mumps begins. […] Orchitis may also occur along with infections of the prostate or epididymis. […] Orchitis may be caused by a sexually transmitted infection (STI), such as gonorrhea or chlamydia. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage.

• #9 Orchitis – WikEM

  https://wikem.org/wiki/Orchitis

  Inflammation of testis – can be infectious (usually) or non-infectious […] Viral orchitis […] Abrupt onset of scrotal pain/swelling 4-7 days after onset of parotitis […] Combination of clinical features and results of imaging/UA […] Ultrasound may show inflammation, epididymitis, and rules out active torsion […] Urinalysis positive for infection in epididymo-orchitis.

• #10 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  Epididymitis and orchitis are commonly seen in the outpatient setting. Men with epididymitis and orchitis typically present with a gradual onset of scrotal pain and symptoms of lower urinary tract infection, including fever. Typical physical findings include a swollen, tender epididymis or testis located in the normal anatomic position with an intact ipsilateral cremasteric reflex. Laboratory studies, including urethral Gram stain, urinalysis and culture, and polymerase chain reaction assay for C. trachomatis and N. gonorrhoeae, help guide therapy. […] Epididymitis and orchitis are inflammation of the epididymis and testes, respectively, with or without infection. These conditions can be subclassified as acute, subacute, or chronic based on symptom duration. Orchitis usually occurs when the inflammation from the epididymis spreads to the adjacent testicle.

• #11 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  Epididymitis and orchitis are commonly seen in the outpatient setting. Men with epididymitis and orchitis typically present with a gradual onset of scrotal pain and symptoms of lower urinary tract infection, including fever. […] Laboratory studies, including urethral Gram stain, urinalysis and culture, and polymerase chain reaction assay for C. trachomatis and N. gonorrhoeae, help guide therapy. […] Epididymitis and orchitis are inflammation of the epididymis and testes, respectively, with or without infection. […] Orchitis usually occurs when the inflammation from the epididymis spreads to the adjacent testicle. […] When evaluating patients with acute testicular or scrotal pain and swelling (acute scrotum), there should be a high index of suspicion for testicular torsion. […] Patients with epididymitis usually present with gradual onset of pain that is localized posterior to the testis and that occasionally radiates to the lower abdomen.

• #12 Orchitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001280.htm

  Orchitis is swelling (inflammation) of one or both of the testicles. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #13 Epididymis

  https://adamcertificationdemo.adam.com/content.aspx?productid=144&isarticlelink=false&pid=1&gid=001280&category=Health%20Topics,%20Symptoms,%20In-Depth%20Reports

  A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of the scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Treatment may include: Antibiotics, if the infection is caused by bacteria. (In the case of gonorrhea or chlamydia, sexual partners must also be treated.), Anti-inflammatory medicines, Pain medicines, Bed rest with the scrotum elevated and ice packs applied to the area. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally.

• #14 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  Epididymitis and orchitis are commonly seen in the outpatient setting. Men with epididymitis and orchitis typically present with a gradual onset of scrotal pain and symptoms of lower urinary tract infection, including fever. […] Laboratory studies, including urethral Gram stain, urinalysis and culture, and polymerase chain reaction assay for C. trachomatis and N. gonorrhoeae, help guide therapy. […] Epididymitis and orchitis are inflammation of the epididymis and testes, respectively, with or without infection. […] Orchitis usually occurs when the inflammation from the epididymis spreads to the adjacent testicle. […] When evaluating patients with acute testicular or scrotal pain and swelling (acute scrotum), there should be a high index of suspicion for testicular torsion. […] Patients with epididymitis usually present with gradual onset of pain that is localized posterior to the testis and that occasionally radiates to the lower abdomen.

• #15 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  When evaluating patients with acute testicular or scrotal pain and swelling (acute scrotum), there should be a high index of suspicion for testicular torsion. In fact, testicular torsion is most commonly misdiagnosed as epididymitis. […] Patients with epididymitis usually present with gradual onset of pain that is localized posterior to the testis and that occasionally radiates to the lower abdomen. Symptoms of lower urinary tract infection, such as fever, frequency, urgency, hematuria, and dysuria, may be present. […] In addition to a careful history and physical examination, diagnostic studies can help confirm epididymitis and orchitis and detect the causative pathogen. […] A Gram stain and culture of swabbed urethral discharge are recommended to detect urethritis and gonococcal infection. Urinalysis and urine culture should also be obtained, preferably on first-void urine samples.

• #16 Acute epididymitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/186

  Diagnostic tests include a Gram stain of urethral secretions, and urine specimens for nucleic acid amplification tests for C trachomatis, N gonorrhoeae, and M genitalium (where available). Urine microscopy and culture is also indicated if urinary pathogens are suspected. […] Key diagnostic factors include presence of risk factors, age 19 years, unilateral scrotal pain and swelling of gradual onset, symptoms 6 weeks’ duration, tenderness, hot, erythematous, swollen hemiscrotum, frequent and painful micturition, and purulent urethral discharge. […] 1st investigations to order include Gram stain of urethral secretions, urine dipstick test, urine microscopy, urine culture, nucleic acid amplification test (NAAT) of urethral secretions or first-void urine for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium, and culture of urethral secretions.

• #17 Inflammation of the Testicle (Orchitis)

  https://www.webmd.com/men/inflammation-testicle-orchitis

  Your doctor may do a series of tests including: […] An ultrasound of the inflamed testicle (or both testicles) to figure out whether you have orchitis or testicular torsion […] A rectal exam to check your prostate for infection […] A urine test to look for STDs and other bacteria that might be responsible for the infection […] Blood tests for HIV and syphilis.

• #18 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  Orchitis is the inflammation of the testis and is usually unilateral. […] Diagnosis is generally on history and physical examination. […] Accurate diagnosis is crucial for efficient management. […] Orchitis diagnosis is usually from history and physical findings. […] Laboratory tests are generally not helpful, but urethral swabs and urine samples may be obtained for routine examination and cultures to rule out urinary tract infection and diagnose sexually transmitted infections as the source. […] When assessing patients with acute testicular or scrotal pain, it is imperative to rule out testicular torsion. […] For such patients, color Doppler ultrasonography of the scrotum is the first choice of investigation. […] Although not typically done, serum immunofluorescence antibody testing is useful to confirm the diagnosis of mumps orchitis.

• #19 Orchitis – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/orchitis

  Orchitis is infection of the testes, typically with mumps virus. […] Diagnosis is clinical. […] History and physical examination usually indicate the diagnosis of orchitis. Urgent differentiation of orchitis from testicular torsion and other causes of acute scrotal swelling and pain is accomplished with color Doppler ultrasonography. […] Mumps can be confirmed by serum immunofluorescence antibody testing. Other infectious agents may be identified by urine culture or serology.

• #20 Orchitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26310

  Orchitis diagnosis is usually from history and physical findings. Laboratory tests are generally not helpful, but urethral swabs and urine samples may be obtained for routine examination and cultures to rule out urinary tract infection and diagnose sexually transmitted infections as the source. […] When assessing patients with acute testicular or scrotal pain, it is imperative to rule out testicular torsion. For such patients, color Doppler ultrasonography of the scrotum is the first choice of investigation. […] Ultrasonography findings in patients with mumps orchitis usually subside by the seventh day. Although not typically done, serum immunofluorescence antibody testing is useful to confirm the diagnosis of mumps orchitis.

• #21 Orchitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/diagnosis-treatment/drc-20375865

  Your healthcare professional starts with your medical history and a physical exam. The exam checks for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. You also might have a rectal exam to check for prostate enlargement or tenderness. […] Tests might include: […] Ultrasound. This imaging test is to find the cause of testicular pain. Ultrasound with color Doppler can show if the blood flow to your testicles is lower than it should be. This could mean you have torsion. A higher than usual blood flow helps confirm the diagnosis of orchitis. […] For orchitis, questions might include: […] What tests do I need? […] Your healthcare professional is likely to ask you questions, including: […] What treatments have you tried? […] What, if anything, seems to ease your symptoms? […] What, if anything, appears to make your symptoms worse?

• #22 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  Orchitis is the inflammation of the testis and is usually unilateral. […] Diagnosis is generally on history and physical examination. […] Accurate diagnosis is crucial for efficient management. […] Orchitis diagnosis is usually from history and physical findings. […] Laboratory tests are generally not helpful, but urethral swabs and urine samples may be obtained for routine examination and cultures to rule out urinary tract infection and diagnose sexually transmitted infections as the source. […] When assessing patients with acute testicular or scrotal pain, it is imperative to rule out testicular torsion. […] For such patients, color Doppler ultrasonography of the scrotum is the first choice of investigation. […] Although not typically done, serum immunofluorescence antibody testing is useful to confirm the diagnosis of mumps orchitis.

• #23 Orchitis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/777456-workup

  Epididymo-orchitis is a clinical diagnosis based on symptoms and signs. […] Diagnosing mumps orchitis can be comfortably made based on history and physical examination alone. Diagnosing mumps orchitis can be confirmed with serum immunofluorescence antibody testing. […] Obtaining a C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) may also be helpful, because elevations of these are more suggestive of inflammation associated with epididymo-orchitis. […] Color Doppler ultrasonography has become the imaging test of choice for the evaluation of acute testicular pain. […] Often, the history and physical examination are enough to make the diagnosis; however, as an adjunct, ultrasonography is highly sensitive for ruling out testicular torsion and for demonstrating inflammation of the testis or the epididymis.

• #24 Orchitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/orchitis?lang=us

  Orchitis (plural: orchitides) is an infection of the testis, which is rarely isolated, and when in conjunction with the epididymis is called epididymo-orchitis. […] Ultrasound is the gold standard investigation. When compared with the other testis in the 'sunglasses view’ features of orchitis include relative: […] almost all cases are associated with epididymitis […] isolated orchitis can be seen in mumps, syphilis and brucellosis. […] primary testicular malignancy should be considered, especially with focal changes.

• #25 Orchitis: Practice Essentials, Etiology

  https://emedicine.medscape.com/article/777456-overview

  Orchitis is an acute inflammatory reaction of the testis secondary to infection. Most cases are associated with a viral mumps infection; however, other viruses and bacteria can cause orchitis. […] The onset of scrotal pain and edema is acute. Because mumps orchitis is responsible for most cases of isolated orchitis, diagnosis in the ED usually is based on a reported history of a recent mumps infection or parotitis with a presentation of testicular edema. […] In sexually active males, urethral cultures and gram stain should be obtained for Chlamydia trachomatis and Neisseria gonorrhoeae. Urinalysis and urine culture should also be obtained. […] Color Doppler ultrasonography is the imaging test of choice for acute testicular pain.

• #26 Orchitis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/orchitis/

  Your doctor is likely to start with your medical history and a physical exam to check for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. Your doctor might also do a rectal examination to check for prostate enlargement or tenderness. […] Your doctor might recommend: […] Ultrasound. This imaging test is the one most commonly used to assess testicular pain. Ultrasound with color Doppler can determine if the blood flow to your testicles is lower than normal — indicating torsion — or higher than normal, which helps confirm the diagnosis of orchitis.

• #27 Orchitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/orchitis?lang=us

  Orchitis (plural: orchitides) is an infection of the testis, which is rarely isolated, and when in conjunction with the epididymis is called epididymo-orchitis. […] Ultrasound is the gold standard investigation. When compared with the other testis in the 'sunglasses view’ features of orchitis include relative: […] almost all cases are associated with epididymitis […] isolated orchitis can be seen in mumps, syphilis and brucellosis. […] primary testicular malignancy should be considered, especially with focal changes.

• #28 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  When evaluating patients with acute testicular or scrotal pain and swelling (acute scrotum), there should be a high index of suspicion for testicular torsion. In fact, testicular torsion is most commonly misdiagnosed as epididymitis. […] Patients with epididymitis usually present with gradual onset of pain that is localized posterior to the testis and that occasionally radiates to the lower abdomen. Symptoms of lower urinary tract infection, such as fever, frequency, urgency, hematuria, and dysuria, may be present. […] In addition to a careful history and physical examination, diagnostic studies can help confirm epididymitis and orchitis and detect the causative pathogen. […] A Gram stain and culture of swabbed urethral discharge are recommended to detect urethritis and gonococcal infection. Urinalysis and urine culture should also be obtained, preferably on first-void urine samples.

• #29 Epididymoorchitis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Epididymoorchitis_differential_diagnosis

  Epididymoorchitis is a major cause of acute scrotum. Other causes of acute scrotum which must be differentiated from epididymoorchitis include testicular torsion and torsion of the testicular appendage. […] If patient presents with symptoms for 6-weeks (symptoms of discomfort or pain in the scrotum, testicle, or epididymis), chronic epididymitis must be suspected. It is usually caused by granulomatous reaction. Mycobacterium tuberculosis is the most common granulomatous disease affecting the testicles and epididymis. Differential must include chronic noninfectious epididymitis. […] Orchitis should be differentiated from other conditions presenting with scrotal pain or lower abdominal pain, fever, nausea and vomiting. […] Orchitis: Unprotected sexual intercourse, Mumps, coxsackie virus infection, Concurrent epididymitis, Congenital abnormalities, Prostatitis, Prostatic hypertrophy or calculi. […] Ultrasound CT scan for diagnosis (Testicular masses or swollen testicles with hypoechoic and hypervascular areas).

• #30 Orchitis the Strange, the Rare and the Unusual: Case Report and Review of the Literature

  https://clinmedjournals.org/articles/iauc/international-archives-of-urology-and-complications-iauc-3-025.php

  Several Orchitis Show Granulomatous Features. […] The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. […] The knowledge of all kind of orchitis that may be encountered in the routinely clinical practice is of paramount importance for a correct diagnosis and to avoid an unnecessary orchiectomy. […] Granulomatous orchitis is a rare disease, first described by Grunberg in 1926. […] The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. […] The differential diagnosis between testicular tumour and granulomatous orchitis is very complex except by histological findings. […] An ultrasound evaluation should be enough to find out several of those pathologies, even if a correct final diagnosis is often reached by a surgical approach only.

• #31 Orchitis the Strange, the Rare and the Unusual: Case Report and Review of the Literature

  https://clinmedjournals.org/articles/iauc/international-archives-of-urology-and-complications-iauc-3-025.php?jid=iauc

  Several Orchitis Show Granulomatous Features. […] The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. […] The knowledge of all kind of orchitis that may be encountered in the routinely clinical practice is of paramount importance for a correct diagnosis and to avoid an unnecessary orchiectomy. […] Granulomatous orchitis is a rare disease, first described by Grunberg in 1926. […] The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. […] A correct diagnosis requires the use of special stains to demonstrate the presence of MG bodies to help in differentiating malakoplakia from other cases of granulomatous orchitis. […] The kinetics of the clinical signs and the suggestive pathological features with hemorrhage and neutrophilic infiltrate are important in the differential diagnosis.

• #32 Diagnosis and classification of autoimmune orchitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/24424181/

  Autoimmune orchitis is characterized by testis inflammation and the presence of specific antisperm antibodies (ASA). It is classified in two categories. Primary autoimmune orchitis is defined by infertility and asymptomatic orchitis associated with ASA (100%) directed to the basement membrane or seminiferous tubules in infertile men, without any systemic disease and usually asymptomatic. Secondary autoimmune orchitis is characterized by symptomatic orchitis and/or testicular vasculitis associated with a systemic autoimmune disease, particularly vasculitis. These patients typically demonstrate testicular pain, erythema and/or swelling. ASA in secondary autoimmune orchitis have been reported in up to 50% of patients, especially in systemic lupus erythematosus patients. The pathogenesis of primary as well as secondary autoimmune orchitis is still unknown. Although the etiology is likely to be multifactorial, testicular inflammation, infection or trauma may induce T cell response with pro-inflammatory cytokine production with a consequent blood-testis-barrier permeability alteration, ASA production and apoptosis of spermatocytes and spermatids. ASA is known to cause immobilization and/or agglutination of spermatozoa, which may block sperm-egg interaction resulting in infertility. Assisted reproduction has been used as an efficient option in primary cases and immunosuppressive therapy for secondary autoimmune orchitis, although there is no double-blind, randomized trial to confirm the efficacy of any treatment regimens for these conditions.

• #33 Autoimmune orchitis: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/autoimmune-orchitis

  Autoimmune orchitis is an extremely rare condition that affects males. […] Autoimmune orchitis can be complicated to diagnose. There are currently no agreed guidelines for doctors to follow. […] A doctor may order blood and urine tests to check for infections. An ultrasound may also be necessary to assess blood flow in the testicles. […] Research into this condition aims to help improve diagnostic methods and treatment guidelines.

• #34 Epididymo-Orchitis Mimicking Malignancy Resulting From Intravesical Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer: An Attempt to Understand Pathophysiology, Diagnostic Challenges, Patients¡¯ Implications and Future Directions | Prasad | Journa

  https://www.journalmc.org/index.php/JMC/article/view/4323/3677

  This case report describes an 85-year-old patient who presented with painless, unilateral right testicular swelling of 2 months duration. This raised the possibility of testicular cancer, especially given his recent treatment for bladder cancer, which included adjuvant intravesical bacillus Calmette-Guerin (BCG) therapy. This poses a diagnostic dilemma regarding tuberculosis (TB) of the testis, BCG complications or a true testicular malignancy. Biochemical markers and a computed tomography (CT) scan showed no evidence of malignancy or disseminated TB. A TB-ELISpot test was negative. An ultrasound of the testis revealed a hypoechoic soft tissue lesion measuring approximately 24 19 mm, with internal vascularity and calcifications, causing a bulge in the testicular capsule with probable extracapsular extension. Based on the clinical suspicion of a testicular tumor, a right inguinal orchidectomy was performed. Histopathologic examination revealed isolated tuberculous orchitis with focal epididymal involvement; the spermatic cord was not involved. Polymerase chain reaction (PCR) testing on the histological sample confirmed the presence of Mycobacterium bovis DNA.

• #35 Unilateral Tuberculous Epididymo-orchitis With Scrotal Fistula | ACS

  https://www.facs.org/for-medical-professionals/news-publications/journals/case-reviews/issues/v3n8/baral-unilateral-tuberculous-epididymo-orchitis/

  A 58-year-old male presented to the outpatient surgery department with unilateral tubercular epididymo-orchitis with scrotal fistula and managed with left orchidectomy with no evidence of primary sites for tuberculosis. […] Long-standing unrecovered history and clinical examination suggested tubercular entity along with ultrasonography facilitated the diagnosis. […] Histopathology was consistent with tubercular epididymo-orchitis evidenced by the presence of granuloma with multinucleated giant cells with caseous necrosis. […] Tubercular epididymo-orchitis should be kept as differential for long-standing cases with scrotal swellings and fistula, if associated, almost confirming the diagnosis in most cases. […] Diagnosis of extrapulmonary tuberculosis requires comprehensive evaluations, including histology, cytology, and microbiological evidence.

• #36 Epididymo-Orchitis Mimicking Malignancy Resulting From Intravesical Bacillus Calmette-Guerin Immunotherapy for Bladder Cancer: An Attempt to Understand Pathophysiology, Diagnostic Challenges, Patients¡¯ Implications and Future Directions | Prasad | Journa

  https://www.journalmc.org/index.php/JMC/article/view/4323/3677

  The utility of fine-needle aspiration cytology (FNAC) as an alternative diagnostic modality for BCG-related epididymo-orchitis has been demonstrated in a few studies. This is particularly important for older patients, as additional surgical interventions may heighten anxiety, morbidity, and mortality. […] Our literature review suggests that treatment for BCG orchitis with a combination of anti-tuberculous therapy should be initiated when there is a high index of clinical suspicion. BCG epididymo-orchitis may be clinically indistinguishable from malignancy, and in such cases, orchiectomy can be performed as both a diagnostic and therapeutic procedure. The literature indicates that anti-tuberculous therapy is an effective treatment for tuberculous epididymo-orchitis, with orchidectomy reserved for non-viable testes with abscess formation.

• #37 Orchitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001280.htm

  Orchitis is swelling (inflammation) of one or both of the testicles. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #38 Orchitis – UF Health

  https://ufhealth.org/conditions-and-treatments/orchitis

  Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment. […] Mumps orchitis has no effective treatment, and the outcome can vary. Men who have had mumps orchitis can become sterile. […] Orchitis may also cause infertility. […] A swollen testicle with little or no pain may be a sign of testicular cancer. If this is the case, you should have a testicular ultrasound. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #39 Epididymitis and Orchitis: Causes, Diagnosis & Treatment

  https://atlanticurologyclinics.com/conditions/epididymitis-and-orchitis/

  Orchitis is the inflammation of one or both testicles. […] There are multiple steps in diagnosing epididymitis and orchitis. The first step is a detailed discussion of symptoms, their duration and severity, and any potential exposure to risk factors, such as sexually transmitted infections or urinary tract abnormalities. […] Determining if epididymitis or orchitis is present and what may be causing the condition often includes several laboratory tests, including: […] Treatment strategies for epididymitis and orchitis aim to alleviate symptoms, eradicate the infection, and prevent potential complications. […] If left untreated, epididymitis and orchitis can lead to serious complications. These can include abscess formation, chronic pain, and, rarely, reduced fertility. Therefore, early diagnosis and prompt treatment are essential.

• #40 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  Symptoms of lower urinary tract infection, such as fever, frequency, urgency, hematuria, and dysuria, may be present. […] In addition to a careful history and physical examination, diagnostic studies can help confirm epididymitis and orchitis and detect the causative pathogen. […] A Gram stain and culture of swabbed urethral discharge are recommended to detect urethritis and gonococcal infection. […] If epididymitis is suspected, polymerase chain reaction assays for C. trachomatis and N. gonorrhoeae should be performed on urethral swab or urine specimens. […] Empiric treatment of epididymitis should be initiated based on likely pathogens, before laboratory testing is complete. […] If gonococcal or chlamydial infection is likely (patients 14 to 35 years of age), treatment should consist of ceftriaxone (Rocephin), a single 250-mg dose intramuscularly, and doxycycline (Vibramycin), 100 mg orally twice daily for 10 days. […] Follow-up is recommended three to seven days after initial evaluation and initiation of treatment to evaluate for clinical improvement and for the presence of a testicular mass.

• #41 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html/1000

  Empiric treatment of epididymitis should be initiated based on likely pathogens, before laboratory testing is complete. Treatment focuses on curing infection, improving symptoms, preventing transmission, and reducing future complications. […] Follow-up is recommended three to seven days after initial evaluation and initiation of treatment to evaluate for clinical improvement and for the presence of a testicular mass.

• #42 Epididymo-orchitis | STI Guidelines Australia

  https://sti.guidelines.org.au/syndromes/epididymo-orchitis/

  Epididymo-orchitis is inflammation of the epididymis, and occasionally the testis. […] In sexually active people of ANY age, Chlamydia trachomatis and Neisseria gonorrhoeae remain the most likely cause of epididymo-orchitis. […] Non-STI causes for epididymo-orchitis are possible in the presence of a urinary tract infection or prostatitis. […] If diagnosis uncertain, Doppler ultrasonography may help exclude testicular infarction, torsion or tumour. […] If diagnosis remains uncertain and pain is severe, refer for urgent surgical assessment. Torsion can result in the loss of the testis within hours. In these cases, it is usually best to refer without ultrasound to avoid delay. […] Follow-up at 4-5 days provides an opportunity to assess treatment response and reassess in light of the test results, including antibiotic sensitivities. […] Men with chlamydia and gonorrhoea should be retested for re-infection after 3 months.

• #43 Orchitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001280.htm

  Orchitis is swelling (inflammation) of one or both of the testicles. […] A physical exam may show: Enlarged or tender prostate gland, Tender and enlarged lymph nodes in the groin (inguinal) area on the affected side, Tender and enlarged testicle on the affected side, Redness or tenderness of scrotum. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to rule out testicular cancer if the testicle does not completely return to normal after treatment. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #44 Orchitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/orchitis

  Orchitis is swelling (inflammation) of one or both of the testicles. […] Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition. […] Orchitis may also occur along with infections of the prostate or epididymis. […] Tests may include: Complete blood count (CBC), Testicular ultrasound, Tests to screen for chlamydia and gonorrhea (urethral smear), Urinalysis, Urine culture (clean catch) — may need several samples, including initial stream, midstream, and after prostate massage. […] Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] You will need further testing to check for testicular cancer if the testicle does not completely return to normal after treatment. […] See your health care provider for an exam if you have testicle problems. […] Get emergency medical help if you have sudden pain in the testicle.

• #45 Epididymo-orchitis | STI Guidelines Australia

  https://sti.guidelines.org.au/syndromes/epididymo-orchitis/

  Epididymo-orchitis is inflammation of the epididymis, and occasionally the testis. […] In sexually active people of ANY age, Chlamydia trachomatis and Neisseria gonorrhoeae remain the most likely cause of epididymo-orchitis. […] Non-STI causes for epididymo-orchitis are possible in the presence of a urinary tract infection or prostatitis. […] If diagnosis uncertain, Doppler ultrasonography may help exclude testicular infarction, torsion or tumour. […] If diagnosis remains uncertain and pain is severe, refer for urgent surgical assessment. Torsion can result in the loss of the testis within hours. In these cases, it is usually best to refer without ultrasound to avoid delay. […] Follow-up at 4-5 days provides an opportunity to assess treatment response and reassess in light of the test results, including antibiotic sensitivities. […] Men with chlamydia and gonorrhoea should be retested for re-infection after 3 months.

• #46 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  Orchitis is the inflammation of the testis and is usually unilateral. […] Diagnosis is generally on history and physical examination. […] Accurate diagnosis is crucial for efficient management. […] Orchitis diagnosis is usually from history and physical findings. […] Laboratory tests are generally not helpful, but urethral swabs and urine samples may be obtained for routine examination and cultures to rule out urinary tract infection and diagnose sexually transmitted infections as the source. […] When assessing patients with acute testicular or scrotal pain, it is imperative to rule out testicular torsion. […] For such patients, color Doppler ultrasonography of the scrotum is the first choice of investigation. […] Although not typically done, serum immunofluorescence antibody testing is useful to confirm the diagnosis of mumps orchitis.

• #47 Orchitis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/777456-workup

  Epididymo-orchitis is a clinical diagnosis based on symptoms and signs. […] Diagnosing mumps orchitis can be comfortably made based on history and physical examination alone. Diagnosing mumps orchitis can be confirmed with serum immunofluorescence antibody testing. […] Obtaining a C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) may also be helpful, because elevations of these are more suggestive of inflammation associated with epididymo-orchitis. […] Color Doppler ultrasonography has become the imaging test of choice for the evaluation of acute testicular pain. […] Often, the history and physical examination are enough to make the diagnosis; however, as an adjunct, ultrasonography is highly sensitive for ruling out testicular torsion and for demonstrating inflammation of the testis or the epididymis.

• #48 Orchitis – Men’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/men-s-health-issues/penile-and-testicular-disorders/orchitis

  Orchitis is usually diagnosed by physical examination. […] Sometimes blood tests and urinalysis are done to identify the mumps virus or other infections. […] Sometimes Doppler ultrasonography is used urgently to assess blood flow to the testes (to rule out testicular torsion, which is an emergency).

• #49 Orchitis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/21658-orchitis

  Orchitis causes pain and swelling in one or both of your testicles. […] Treatment usually involves antibiotics. […] A healthcare provider will perform a physical exam to check for tenderness and swelling in your testicles. To confirm their diagnosis, they may also order additional tests. […] A healthcare provider may order the following tests to diagnose orchitis: Blood tests, urinalysis (pee test) and/or urine culture. These tests check for bacterial and viral infections, including STIs. […] Orchitis symptoms typically start to go away a few days after you start treatment. But it can take weeks or even months for the swelling to go away completely. […] With proper diagnosis and treatment, the outlook for orchitis is good. Infertility and other long-term problems are rare.

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