Title: Evaluation of Various Etiological Factors & Clinical Presentations of Epididymo-Orchitis at a Tertiary Care Centre
Authors: Navneet Parashar, Shivraj Meena, R.S Meena
DOI: http://dx.doi.org/10.18535/jmscr/v4i5.48
Purpose- No Indian data exists on the incidence and prevalence of epididymo-orchitis. Western data suggest that the incidence of the disease is highest among young males aged between 18 and 35 years of age. Our aims were to establish various etiological factors in development of epididymo-orchitis. Methods- This prospective study was conducted on 50 patients of Epididymitis / Epdididymo-orchitis. Results: Most common age of presentation of epididymo-orchitis is between 30-50 years. Urinary complain is present in more than half (54%) of patients at the time of presentation. In acute epididymo-orchitis, fever (44%) and urethritis (17%) were found commonly. Both epididymis and testis are involved in most of acute cases (95%). While 33% of chronic cases involved only epididymis E. coli was the most common organism which was isolated in urine cultures (57.8% among the isolated organisms). Mycobacterium tuberculosis infection was found in around 10% of cases. Conclusion: E. coli was the most common organism which was isolated in urine cultures. Early and proper empirical treatment (and later on according to culture sensitivity report) with bed rest and scrotal support should be started as early as possible. This prevents the complications and conversion to chronic form. Key words- Epididymo-orchitis, Gonococcal urethritis, Chlamydia. Dysurea 1. Mittemeyer BT, Lennox KW, Borski AA. Epididymitis: a review of 610 cases. J Urol. 1966;95:390-392. 2. Berger RE, Kessler D, Holmes KK. Etiology and manifestations of epididymitis in young men: correlations with sexual orientation. J Infect Dis. 1987;155:1341-1343. 3. Centers for Disease Control and Prevention. Trends in Reportable Sexually Transmitted Diseasesin the United States, 2006. Atlanta: Centers for Disease Control and Prevention, Dept of Health and Human Services; November 2007. 4. Tracy CR, Steers WD, Costabile R. Diagnosis and management of epididymitis. Urol Clin North Am. 2008;35:101-108. 5. National Center for Health Statistics. [Internet] National Ambulatory Medical Care Survey, 2002. Available from: http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm. 6. Kaver I, Matzkin H, Braf ZF. Epididymo-orchitis: a retrospective study of 121 patients. J Fam Pract. 1990;30(5):548-552. 7. Williams RD, Cooper CS, Donovan JF. Acute Epididymitis. In: Current surgical diagnosis and treatment. Way LW, Doherty GM, editors. New York: Mc Graw Hill; 2002. p.1040. 8. WHO. Tackling the sexually transmitted diseases in the periphery, the syndromic approach. 2006;2. 9. Thomas H Trojian, Timothy S Lishnak Diana Heiman 2009 Apr : an overview epididymitis and orchitis; Am Fam Physician 2009 April 79(7) ; 583-7, 19378875. 10. A.A. Hoosen, NO Farrel, J Van Den Ende. Microbiology of acute epididymitis in a developing community. Genitourin Med. 1993 Oct;69(5):361-3. 11. C.M. Beard R.C. Benson Jr. P P Kelalis LR Elveback LT Kurland; Incidence and outcome of mumps orchitis in Rochester Minnesota 1935 to 1974 ; Mayo Clinic Prov 1977 Jan ; 52(1) 3-7 609284 Cit 36. 12. D A Hawkins, D Taylor Robinson, B.J. Thomas JR Harris ; Microbiological survey of acute epididymitis. Genitourin Med. 1986 Oct; 62(5): 342–344. 13. Melkos MD, Asbach HW; Epididymitis aspects concerning etiology and treatment J. Urol; 1987 Jul : 138 (1) 83-6. 14. Yamamoto M Hibi M Miyake K. dept of urology, Nagoya University of medicine Chlamydia trachomatis infection in young men with acute epididymitis and their sexual partner; Hinyokika Kiyo 1993; Sep 39(9): 819-22. 15. Huan-Yun Liu ; Yian-Tzueng Fu, Ching-Jiunn Wu Guang-Huan Sun. Tuberculous epididymitis ; A case report and literature review ; Asian Journal of Andrology (2005) 7, 329-332. 16. Thappa DM, Kaimal S. Sexually transmitted infections in India: Current status except human immunodeficiency virus/acquired immunodeficiency syndro-me). Indian J dermatol 2007; 52:78-82. Abstract
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