[24M] With testicular swelling and fever

Patient Description

A 24-year-old male reports experiencing soreness and swelling in the testicles, accompanied by a high fever that occurs in the evening and resolves by morning. The testicular swelling began gradually about 3 to 4 days ago, with the testicles feeling hard and very sensitive, although the scrotum itself feels unchanged. The patient has attempted to relieve symptoms with Ibuprofen but is unsure of its effectiveness. The patient denies any recent trauma or injury to the area but notes a work environment that involves crawling on the stomach or hands and knees. In the last day or two, the patient has experienced dysuria and increased urinary frequency with decreased output. The fever, consistently around 103.0°F, is accompanied by dizziness and lightheadedness. The patient is married and has only one sexual partner, with no recent STI testing or symptoms suggestive of an STI. There is no recent travel history or known exposure to infections. The patient has not reported any other significant medical history or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—testicular swelling and soreness, fever, pain during urination, and dizziness—there are a few possible explanations:

  1. Epididymitis: This is an inflammation of the epididymis, often caused by infection. It can lead to swelling and pain in the testicles, and sometimes fever. It's commonly associated with urinary tract infections or sexually transmitted infections (STIs).

    • Treatment: Typically involves antibiotics to treat the infection, along with pain relief medications. It's important to see a healthcare provider for a proper diagnosis and treatment plan.

  2. Orchitis: This is an inflammation of one or both testicles, which can be caused by bacterial or viral infections. It can cause swelling, pain, and fever.

    • Treatment: Similar to epididymitis, treatment may involve antibiotics if a bacterial infection is present, and supportive care for viral causes.

  3. Testicular Torsion: This is a medical emergency where the testicle twists, cutting off its blood supply. It causes sudden, severe pain and swelling. While your symptoms developed gradually, it's important to rule this out.

    • Treatment: Requires immediate medical attention and possibly surgery to untwist the testicle and restore blood flow.

What you can do

  1. Seek Medical Attention: It's important to see a healthcare provider as soon as possible to determine the cause of your symptoms and receive appropriate treatment. This is especially important given the fever and pain you're experiencing.

  2. Symptom Management: While waiting to see a doctor, you can continue taking over-the-counter pain relievers like ibuprofen to help manage pain and fever. Be sure to follow the dosing instructions on the package.

  3. Rest and Hydration: Rest as much as possible and stay hydrated, especially since you're experiencing fever and dizziness.

  4. Use MDandMe: Consider using the MDandMe app to journal your symptoms, track your progress, and share this information with your healthcare provider. This can help in managing your condition and ensuring you receive the best care.

What you should look out for

  • Worsening Symptoms: If you notice increased pain, swelling, or redness, or if your fever persists or worsens, seek medical attention immediately.
  • New Symptoms: Be alert for any new symptoms, such as nausea, vomiting, or changes in the appearance of your testicles.
  • Emergency Signs: If you experience severe pain that comes on suddenly, or if you feel faint or have difficulty breathing, seek emergency medical care.

Remember, while this information can help guide you, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago

People Also Ask

What are the common causes of testicular swelling and soreness?

Common causes of testicular swelling and soreness include infections such as epididymitis or orchitis, trauma, and in rare cases, testicular torsion. It's important to consult a healthcare provider for an accurate diagnosis.

How can I differentiate between epididymitis and testicular torsion?

Epididymitis usually develops gradually and is often accompanied by fever and urinary symptoms, while testicular torsion typically causes sudden, severe pain and swelling. Testicular torsion is a medical emergency and requires immediate attention.

What are the typical treatments for epididymitis?

Treatment for epididymitis typically involves antibiotics to address any bacterial infection, along with pain relief medications. Rest and supportive care, such as scrotal elevation and applying ice packs, may also be recommended.

When should I seek emergency medical attention for testicular pain?

You should seek emergency medical attention if you experience sudden, severe testicular pain, swelling, or if you feel faint or have difficulty breathing. These could be signs of testicular torsion or another serious condition.

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