Acute Scrotal Swelling or Pain

exp date isn't null, but text field is

CLINICAL DESCRIPTION

Causes

  • Chlamydia trachomatis
  • Neisseria gonorrhea

CLINICAL FEATURESSIGNS AND SYMPTOMS

  • Scrotal swelling
  • Scrotal pain
  • Urethral discharge
  • Dysuria
  • Frequency of micturition
  • Fever

Distinguish from scrotal swelling/pain due to:

  • Other long-standing causes, e.g. Scrotal hydrocele, varicocele, inguinal hernia
  • Recent/acute illness, e.g. Testicular torsion or trauma, inguinal hernia

INVESTIGATIONS

  • Urethral swab for culture
  • Urine culture and sensitivity
  • Ultrasound scan of the scrotum

Note: Thorough history and physical examination are necessary to exclude potentially life- threatening conditions and to determine whether immediate surgical attention is required

TREATMENT NON-PHARMACOLOGICAL

  • Bed rest
  • Cold compress If there is no evidence of painful and/or swollen scrotum, look for signs of another STI and if present treat appropriately
  • Scrotal support until inflammation and fever subsides

PHARMACOLOGICAL

  • Even if the presumptive diagnosis is an STI, treat all patients and partners for gonorrhea and chlamydia infection:
    • Give Ceftriaxone 250mg IM STAT and
    • Give Azithromycin 1g orally as single dose.
    • Additional therapy for the patient