Orchitis

Changed by Daniel J Bell, 29 Oct 2020

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Orchitis (plural: orchitides) is an infection of the testicle, which is rarely isolated, and when in conjunction with the epididymis is called epididymo-orchitis.

Pathology

Usually, bacteria retrogradely seed into the testis from the bladder or prostate. It can also be secondary to viral infection (e.g. mumps, Coxsackie virus).

Associations

almost all cases are associated with epididymitis
isolated orchitis can be seen in mumps ~~and syphilis~~, syphilis and brucellosis⁶

Radiographic features

Ultrasound

Ultrasound is the gold standard investigation. When compared with the other testis in the 'sunglasses view' features of orchitis include relative:

hypoechogenicity: focal or diffuse
hypervascularity: focal or diffuse
swelling
scrotal wall thickening

A complex/septated hydrocele can be seen in the ipsilateral scrotum.

Differential diagnosis

intermittent testicular torsion ⁵
- reperfusion after intermittent torsion can present similarly on Doppler ultrasound with increased flow, but the patient's history allows differentiation
primary testicular malignancy should be considered, especially with focal changes

-<p><strong>Orchitis</strong> is an infection of the <a href="/articles/testis-1">testicle</a>, which is rarely isolated, and when in conjunction with the <a href="/articles/epididymis">epididymis</a> is called <a href="/articles/epididymitis">epididymo-orchitis</a>.</p><h4>Pathology</h4><p>Usually, bacteria retrogradely seed into the testis from the <a href="/articles/urinary-bladder">bladder</a> or <a href="/articles/prostate">prostate</a>. It can also be secondary to viral infection (e.g. <a href="/articles/mumps">mumps</a>, Coxsackie virus). </p><h5>Associations</h5><ul>
+<p><strong>Orchitis</strong> (plural: orchitides) is an infection of the <a href="/articles/testis-1">testicle</a>, which is rarely isolated, and when in conjunction with the <a href="/articles/epididymis">epididymis</a> is called <a href="/articles/epididymitis">epididymo-orchitis</a>.</p><h4>Pathology</h4><p>Usually, bacteria retrogradely seed into the testis from the <a href="/articles/urinary-bladder">bladder</a> or <a href="/articles/prostate">prostate</a>. It can also be secondary to viral infection (e.g. <a href="/articles/mumps">mumps</a>, Coxsackie virus). </p><h5>Associations</h5><ul>
~~-<li>isolated orchitis can be seen in <a href="/articles/mumps">mumps</a> and syphilis</li>~~
+<li>isolated orchitis can be seen in <a href="/articles/mumps">mumps</a>, syphilis and <a href="/articles/brucellosis">brucellosis</a> <sup>6</sup>
+</li>

References changed:

6. Baykan A, Sayiner H, Inan I. Brucella and Non-Brucella Epididymo-Orchitis: Comparison of Ultrasound Findings. Med Ultrason. 2019;21(3):246. <a href="https://doi.org/10.11152/mu-1871">doi:10.11152/mu-1871</a>

Updates to Synonym Attributes

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