Epididymitis

HISTORY:

‍RightLeft scrotal ‍painswelling for ‍ ‍hoursdays

‍pain

‍swelling

‍redness

‍fever, up to ‍°, over ‍ ‍hoursdays

‍penile discharge

‍blood in semen

‍lower back pain

‍abdominal pain

‍nausea

‍vomiting

‍dysuria

‍urinary frequency

Onset: ‍gradualsudden, following ‍

Worsening factors: ‍none

Treatments tried: ‍none, ‍effectiveineffective



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

CVA tenderness: ‍negativepositive on Rpositive on L

Genital: ‍normal, testicles ‍normal, penis ‍normal



ASSESSMENT:

‍Epididymitis ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Urinalysis

- Urine culture

- STI testing for chlamydia and gonorrhea

- Blood work: ‍CBC, ‍CRP, ‍creatinine

- Ultrasound of scrotum if does not resolve after 72 hours

- ‍Antibiotics

- ‍Analgesics

- Scrotal support

- Ice packs

- Sexual partners treatment

- Abstinence until treatment completed and symptoms resolved

- Referral to urologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as fever, vomiting, or increased pain

- Go to ER if severe abdominal pain, severe vomiting, or fever occurs