Orchitis – Causes, Symptoms and Diagnosis

Definition: is an inflammatory condition of one or both testicles in males, usually caused by a viral or bacterial infection.

Most cases of orchitis in children are caused by infection with the mumps virus.

Orchitis caused by a bacterial infection develops most commonly from the progression of epididymitis, an infection of the tube that carries semen from the testicles. This is called epididymal-orchitis.

Most cases of mumps orchitis occur in prepubertal men (less than 10 years old), while most cases of bacterial orchitis occur in sexually active men, or in men older than 50 years with benign prostatic hypertrophy.

Causes

Orchitis in children occurs most commonly as a result of a viral infection. The virus that causes mumps is more commonly implicated as the cause of orchitis.

Approximately one third of children will develop orchitis due to mumps infection. It is more common in young children, and testicular inflammation typically develops 4-6 days after the onset of mumps.

There are reports of cases of mumps orchitis that occur after immunization with the mumps, measles, and rubella vaccine, but this is rare.

Other less common viral organisms that can cause orchitis include varicella, coxsackievirus, echovirus, and cytomegalovirus (associated with infectious mononucleosis).

Less commonly, orchitis can be caused by a bacterial infection.

In general, most cases of bacterial orchitis occur from the progression and spread of epididymitis (inflammation of the spiral tube in the back of the testicle), either from a sexually transmitted disease or from a prostate gland. / urinary tract infection.

Bacteria that can cause orchitis of the prostate gland / urinary tract infections include: Escherichia coli, Klebsiella pneumoniae, Seudomonas aeruginosa, and Staphylococcus and Streptococcus species.

Bacteria that cause sexually transmitted diseases, such as gonorrhea, chlamydia, and syphilis, can cause orchitis in sexually active men, typically between the ages of 19-35.

People can be at risk if they have many sexual partners, are involved in high-risk sexual behavior, if their sexual partner has had an STD, or if the person has a history of STDs.

Individuals may be at risk for orchitis not sexually transmitted if they have not been immunized against mumps, if they have frequent urinary tract infections, if they are over 45 years of age, or if a catheter is often placed in the bladder.

symptom

Symptoms associated with orchitis can vary from mild to severe, and inflammation can affect one or both testicles.

Patients may experience rapid onset of pain and swelling, or symptoms may appear more gradually. Symptoms of orchitis may include the following:

  • Swelling of the testicles.
  • Testicular redness.
  • Testicular pain and sensitivity
  • Fever and chills.
  • Nausea.
  • Upset and fatigue.
  • Headache.
  • Body pain.
  • Pain when urinating.

In the epididymal orchitis, the symptoms may appear and progress more gradually.

Epididymitis initially causes a localized area of ​​pain and swelling in the back of the testicle for several days.

Later, the infection increases and spreads to involve the entire testicle.

Pain or burning may also be seen before or after urination and discharge from the penis.

When to seek medical care for orchitis

People who experience testicular pain, redness or swelling should promptly seek medical attention and evaluation.

Do not delay medical attention because other emergency conditions, such as testicular torsion (torsion of the spermatic cord), are also characterized by testicular pain and sensitivity.

If the affected man can not see his doctor immediately, he should go to an emergency department. Also, if the person has been evaluated and their condition continues to get worse, you should seek medical attention.

Diagnosis

In general terms, the diagnosis of orchitis can be established after a history and the physical examination has been performed by a health professional.

However, imaging studies and laboratory tests can be performed to evaluate and exclude other medical conditions that may have symptoms similar to those of orchitis.

An ultrasound of the affected testicle (s) may be ordered to exclude other conditions (eg, testicular torsion, abscess or epididymitis) that may cause similar symptoms.

With a rectal exam, a health professional can check the prostate gland to detect the infection.

This test is necessary because the antibiotic treatment will be used for a longer period of time if the infection involves the prostate gland.

A discharge sample drawn from the urethra, the tube that forms the opening at the end of the penis, can be obtained to identify which bacteria are responsible for the infection if a sexually transmitted disease is suspected.

Urinalysis can be obtained depending on the patient’s symptoms.

Caring for orchitis symptoms in the home.

Home care together with proper medical treatment can help improve symptoms.

Non-steroidal anti-inflammatory drugs such as ibuprofen (Advil or Motrin, for example) or naproxen (Aleve) and acetaminophen (Tylenol) may help with pain. Narcotic analgesics may be prescribed at the discretion of the health professional if the pain is severe.

Raising the scrotum with tight briefs or sports support can increase comfort. Apply ice packs to the scrotal area.

Ice should not be applied directly to the skin because this can cause frostbite. On the contrary, the ice should be wrapped in a cloth and then applied to the scrotum.

Ice packs can be applied for 10-15 minutes at a time, several times a day for the first 1-2 days. This will help reduce swelling (and pain).