Epididymo-orchitis suspected to be caused by a urinary tract pathogen

Epididymo-orchitis in males¹ who are not sexually active is likely to be caused by an organism from the urinary tract.

For adults with epididymo-orchitis suspected to be caused by a urinary tract pathogen, treat as for acute bacterial prostatitis.

For prepubertal males with epididymo-orchitis suspected to be caused by a urinary tract pathogen, perform urinalysis; more than 80% of cases are not bacterial and do not require antibiotic therapyCristoforo, 2021. If urinalysis is negative for leucocyte esterase and nitrite, treat symptomatically with paracetamol or ibuprofen – see Oral drugs for mild, acute nociceptive pain in children Gkentzis, 2014. If urinalysis is positive for leucocyte esterase or nitrite, take a midstream urine sample for microscopy, culture and susceptibility (see Investigations for the diagnosis of UTI in children) and treat as for a urinary tract infection for 14 days – see Overview of urinary tract infection (UTI) in children.

¹ In this topic, the term ‘male’ is used to include all people presumed male at birth.Return