Infectious Disease Compendium

Epididymitis

Diagnosis

Acute painful unilateral scrotum. Granulomatous epididymitis is not uncommon after BCG (a treatment for bladder cancer) and can get worse with each treatment.

Epidemiologic Risks

Sex, BCG.

Microbiology

Age > 35: coliforms (such as E. coli) or Pseudomonas.

Any age (usually < 35): C. trachomatis and N. gonorrhoeae (I always assume that people over age 35 (being > 50 I will neither confirm nor deny that bias) do not have sex, although the oldest clap I have seen was an 85 yo male. But that was in L.A. And what to do if your age is exactly 35 remains a mystery).

Empiric Therapy

For the elderly, non sexually transmitted, a quinolone pending cultures. For STD's treat accordingly.

Pearls

Rants

ICD9 Codes (Soon to be supplanted by ICD10)

Epididymitis (non-venereal) 604.90; with abscess 604.0; acute 604.99; chlamydial 099.54; gonococcal (acute) 098.0; recurrent 604.99; syphilitic 095.8 ; tuberculous 016.4.