附睾炎
医学
睾丸炎
沙眼衣原体
淋病奈瑟菌
睾丸扭转
头孢曲松
内科学
妇科
外科
微生物学
抗生素
生物
作者
Thomas H. Trojian,Timothy S. Lishnak,Diana L. Heiman
出处
期刊:PubMed
日期:2009-04-01
卷期号:79 (7): 583-7
被引量:70
摘要
Epididymitis and orchitis are commonly seen in the outpatient setting. Men between 14 and 35 years of age are most often affected, and Chlamydia trachomatis and Neisseria gonorrhoeae are the most common pathogens in this age group. In other age groups, coliform bacteria are the primary pathogens. Men with epididymitis and orchitis typically present with a gradual onset of scrotal pain and symptoms of lower urinary tract infection, including fever. This presentation helps differentiate epididymitis and orchitis from testicular torsion, which is a surgical emergency. Typical physical findings include a swollen, tender epididymis or testis located in the normal anatomic position with an intact ipsilateral cremasteric reflex. Laboratory studies, including urethral Gram stain, urinalysis and culture, and polymerase chain reaction assay for C. trachomatis and N. gonorrhoeae, help guide therapy. Initial outpatient therapy is empirical and targets the most common pathogens. When C. trachomatis and N. gonorrhoeae are suspected, ceftriaxone and doxycycline are recommended. When coliform bacteria are suspected, ofloxacin or levofloxacin is recommended.
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