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Epididymitis, Pediatric

Melissa T. Sanford, MD and Hillary L. Copp, MD, MS Reviewed 10/2018
 


BASICS

DESCRIPTION

Epididymitis is an acute inflammation of the epididymis which can cause severe scrotal pain. It is important to differentiate epididymitis from testicular torsion or testicular appen...

DIAGNOSIS

HISTORY

  • It is not always possible to distinguish between testicular torsion, testicular appendage torsion, and epididymitis based on history and physical exam.

  • Duration of symptoms is longer t...

TREATMENT

GENERAL MEASURES

Given that the majority of acute epididymitis is nonbacterial, initial treatment should be supportive with analgesics, nonsteroidal anti-inflammatory drugs, bed rest, scrotal...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Schedule for follow-up appointment in 2 to 4 weeks to ensure resolution of epididymitis.

  • Recommend referral to pediatric urology.

  • Children <1 year of age and any...

ADDITIONAL READING

  • Cappèle O, Liard A, Barret E, et al. Epididymitis in children: is further investigation necessary after the first episode? Eur Urol.  2000;38(5):627–630. [View Abstract on Ovid...

CODES

ICD9

  • 604.90 Orchitis and epididymitis, unspecified

  • 604.99 Other orchitis, epididymitis, and epididymo-orchitis, without mention of abscess

  • 604.91 Orchitis and epididymitis in diseases classified el...

FAQ

  • Q: What is the best empiric antibiotic?

  • A: Empiric antibiotic choice should be based on local antibiogram. Typically reasonable choices include Keflex, Bactrim, or a fluoroquinolone.

  • Q: What should ...

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