Epididymitis Case Study

Case Presentation: A 12-year-old boy presented to his primary care provider (PCP) with a chief complaint of right-sided testicular pain and swelling. The swelling started to occur approximately five days ago, with gradual onset of pain. The pain has gotten significantly worse throughout the day he presented to clinic. He rates the pain as an 8/10. The pain occurs when the patient is walking, lying down, and especially when he is lying on his side. The testicle looks red and inflamed. There was no known injury to the site, and no recent illnesses. No recent contact sports. The patient tried placing cool cloths to the site, which helped to relieve some of the pain, but that did not decrease the swelling. The patient took Tylenol and

In men 14 to 35 years of age, epididymitis is most commonly caused by sexually transmitted Neisseria gonorrhoeae or Chlamydia trachomatis infection (Manavi, Scott, & Stewart, 2005). Nonspecific bacterial epididymitis is caused by various aerobic bacteria and is often associated with anatomic abnormalities. In those younger than 14 years or older than 35 years, epididymitis is generally caused by infection with common urinary tract pathogens, such as Escherichia coli ((Trojian, Lishnak, & Heiman, 2009). Risk factors in men older than 35 years and in prepubertal boys include recent urinary tract surgery or instrumentation and anatomic abnormalities, such as prostatic obstruction in older men and posterior urethral valves or meatal stenosis in prepubertal boys (Luzzi & O’Brien, 2001). Non-infectious epididymitis is common in younger males. One study found that the annual incidence of epididymitis in boys two to 13 years of age is 1.2 per 1,000, and that the condition in this age group is primarily a postinfectious inflammatory reaction to common cold viruses that follows a benign course (Somekh, Gorenstein,& Serour, 2004). As a result, a urine sample can indicate whether or not a bacterium is the causative