Table of Contents
- epididymo-orchitis is inflammation of the testes and usually falls into one of 4 main causes:
Mx of suspected epididymo-orchitis in the ED
- in adolescents and younger men, one must first exclude possible torsion of the testes - consider urgent surgical consult within 1 hour in at risk patients, in very low risk patients an ultra-sound examination may be indicated.
- send MSU m/c/s in all patients
- consider sending urethral swab or 1st pass urine for Chlamydia and Gonococcal PCR in sexually active men
probable UTI cause
- NB. the following are derived from ATG 2012 1) but do not cover Pseudomonas aeruginosa or enterococci.
- trimethoprim 300 mg (child: 6 mg/kg up to 300 mg) orally, daily for 14 days, or,
- cephalexin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 12-hourly for 14 days, or,
- amoxycillin+clavulanate 500+125 mg (child: 12.5+3.1 mg/kg up to 500+125 mg) orally, 12-hourly for 14 days, or,
- if resistance is suspected in adults, norfloxacin 400 mg orally, 12-hourly for 14 days.
- gentamicin 4 to 6 mg/kg (see Table 2.24) (child less than 10 years: 7.5 mg/kg; 10 years or more: 6 mg/kg) IV, for 1 dose, then determine dosing interval for a maximum of either 1 or 2 further doses based on renal function
- in patients with HS to penicillins, gentamicin alone may be adequate, but if gentamicin contraindicated then:
- ceftriaxone 1 g (child: 25 mg/kg up to 1 g) IV, daily
probable STD cause
- ceftriaxone 500 mg in 2 mL of 1% lignocaine IM, or 500 mg IV, daily for 3 days (for gonorrhoea)
- azithromycin 1 g orally, as a single dose
- PLUS EITHER:
epididymo-orchitis.txt · Last modified: 2013/11/26 05:35 by 127.0.0.1