[34M] With severe scrotal swelling, pain, and systemic symptoms

Patient Description

A 34-year-old male presents with a four-day history of progressive scrotal swelling and bright red discoloration, initially starting on one side before affecting both sides. The patient rates the associated pain as 10/10, describing it as sharp and exacerbated by recent heavy lifting. Accompanying symptoms include severe intermittent fever, chills, body aches, extreme fatigue, and weakness that began concurrently with the scrotal symptoms. The patient also reports anorexia since the onset of pain. There is no history of recent injury, changes in urination, or sexual risk factors. The patient denies any past medical history, medication use, allergies, or weight changes. A family history of hernias is noted. The patient has not taken a Covid test and has not noticed any changes in the orientation of the testicles.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible conditions:

  • Epididymitis: This is inflammation of the tube at the back of the testicle that stores and carries sperm. It is often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Symptoms can include testicular pain and swelling, fever, and chills.

  • Orchitis: This is inflammation of one or both testicles, usually caused by an infection. Orchitis can be caused by many types of bacteria and viruses. The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty.

  • Testicular Torsion: This is a serious condition caused by the spermatic cord to the testicle becoming twisted. It can cause severe pain and swelling in the scrotum. This is a medical emergency that needs to be treated right away to prevent lasting damage to the testicles.

  • Inguinal Hernia: This occurs when part of your intestine protrudes through a weak spot in your abdominal muscles near the groin. Most inguinal hernias enlarge over time if not repaired surgically. In men, the protrusion may descend into the scrotum.

What you can do

Given the severity of your symptoms, you should seek immediate medical attention. These conditions can be serious if not treated promptly. You should go to the emergency department right away.

What you should look out for

Watch for sudden, severe testicle pain. Testicle pain is always a reason to seek urgent medical care. If you have testicle pain and swelling, especially if it's sudden, seek medical care right away.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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8 mo ago


People Also Ask


What are the common causes of scrotal swelling and pain?

Common causes of scrotal swelling and pain include infections such as epididymitis or orchitis, testicular torsion, and inguinal hernias. Each condition has distinct characteristics and requires different treatments.


How can I differentiate between epididymitis and testicular torsion?

Epididymitis often presents with gradual onset of pain and swelling, sometimes accompanied by fever and urinary symptoms. Testicular torsion, on the other hand, typically causes sudden, severe pain and swelling and is a medical emergency requiring immediate attention.


What are the potential complications if conditions like orchitis or testicular torsion are not treated promptly?

If conditions like orchitis or testicular torsion are not treated promptly, they can lead to complications such as infertility, chronic pain, or even loss of the affected testicle due to lack of blood supply in the case of torsion.


Can heavy lifting cause scrotal swelling or related symptoms?

Yes, heavy lifting can potentially cause or exacerbate conditions like inguinal hernias, which may lead to scrotal swelling. It is important to seek medical evaluation to determine the exact cause of symptoms.

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