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Here is an approach to management and treatment of epididymo-orchitis , a serious medical case .

What is epididymitis ?

Epididymitis is an infection or inflammation of the epididymis ( which is a bundle of  small tubes found next to each testicle  ) usually due to bacterial infection  , epididymitis occurs in males at any age but more frequently at 20-39 years old .

What is Orchitis ?

Orchitis is an infection or inflammation of the testis itslef .
- Usually, Epididymo-orchitis is caused by spread of urinary tract infection or sexually transmitted diseases ( STDs) .Mumps virus can alson cause orchitis .
- Epididymo-orchitis may follow a trauma to or near the lower urinary tract .

What are the signs and symptoms of epididymo-orchitis?

-Epididymo-orchitis usually manifests as pain (severe) in the area of testis or groin , swelling and redness of the scrotum .

- Penile discharge and blood in urine may occur .

How to manage and treat epididymo-orchitis ?

- Testicular torsion should be excluded first ( consultation of urologist ) .

-  Anti-bacterian therapy should be started immediately without waitiong for laboratory results .

- In case of STDs , sexual partners should recieve treatment .

A. Supportive therapy
1. Bed rest Or at lest reduction of physical activity .
2. Sitz baths .
3. Ice packs, which decreases swelling and pain  .
4. Scrotal support and elevation .
B.Medical treatment
1. Antibiotics
 The recommended regimen is as follows :
- Ceftriaxone 250 mg Intra-muscular single dose .
- Doxycycline 100 mg tab. / Two tablets daily for 10 days .
* In cases of Epididymitis caused by enteric organisms

- Levofloxacin 500 mg orally once daily for 10 days .

OR
- Ofloxacin 300 mg orally twice a day for 10 days .

2. Anti-inflammatory medications as Alphintern tablets .

If the patient doesn't respond to treatment in the first 48 hours , Re-evaluation is recommended .

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