S/S

• Painful Scrotal Mass
  • Treat as !Testicular torsion → Bring to OR
  • If Scrotal US rules out torsion → Treat by Abx
• Progressive Dysuria, Fever
• On Male GU Exam (Testis, Penis) :
  • Cyst
  • tenderness
  • induration, swelling
  • Positive Prehn's sign

Mimicker

• !Testicular torsion (negative Prehn’s Sign)

Etiology

• Bacteria from Urine

• STIs → most common Chlamydia & Gonorrhea

  

• Mumps (orchitis)

• Anal → can be from E. Coli

Treatment

Antibiotic Regime

• Genital Sex:
  • Cover C & G
  • PO Doxycycline + IM CTX - Ceftriaxone (3 gen IV) x 10-14 d
• Anal Sex:
  • Cover E. coli and C & G
  • PO Levofloxacin (Gen III) + IM CTX - Ceftriaxone (3 gen IV)