In our case study section, we regularly upload interesting case study articles of different medical cases shared by our teams of expert and superspecialist doctors. Today we have a case study of epididymo-orchitis shared by an infectious disease specialist Dr. Pratik savaj.
What is epididymo-orchitis?
The term involves two body parts. One is epididymis and its inflammation is referred to as epididymitis. Another is the testicle and its inflammation is referred to as orchitis. When the inflammation is present in both the organs it is referred to as epididymo-orchitis.
Symptoms of epididymo-orchitis
It is a very painful condition with enlargement, tenderness, and redness of the scrotal area.
It is caused by different kinds of infectious agents. Bacterial infections include E. coli, chlamydia trachomatis, gonorrhea, brucella infection, etc.
Viral infections such as mumps and other causes include local or surgical injury to the area, tuberculosis, side effects of some medications, etc.
Treatment of epididymo-orchitis
It depends on causative factors. Usually, it responds very well to antibiotics when the cause is a bacterial infection. Symptomatic treatment is provided to relieve pain and swelling.
Our interesting case study
This was a case of 65 years old male patient who was apparently healthy. But for the last 3 months, he has had recurrent right testicular swelling and pain with high-grade fever.
For the condition, he received multiple antibiotics and every time has a good response with a doxycycline antibiotic. But the same complaints reappeared many times.
A detailed history was taken. In history, it was found that he was drinking unpasteurized milk for 6 months. According to this history, Brucella was suspected and an investigation was done owing to this consideration. And see, Brucella IgM came positive.
Final diagnosis: Brucella epididymo-orchitis
The patient was started with oral Rifampin with doxycycline. On the follow-up visit, there was no fever and scrotal swelling got reduced.
In brucellosis epididymo-orchitis as a first symptom is not common. But when no cause is found for the condition, brucella infection must be investigated and people living in endemic regions should be evaluated for brucellosis.
I am again thankful for sharing such an interesting educational case with us:
Dr. Pratik Savaj
Infectious disease (ID) specialist, serving at
SCID-AI Clinic (Surat Clinic of Infectious Disease and Adult Immunization) and
IDCC Hospital (Infectious Disease and Critical Care)
Surat City, Gujarat, India
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