TAILIEUCHUNG - Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 6)

Epididymitis Acute epididymitis, almost always unilateral, produces pain, swelling, and tenderness of the epididymis, with or without symptoms or signs of urethritis. This condition must be differentiated from testicular torsion, tumor, and trauma. Torsion, a surgical emergency, usually occurs in the second or third decade of life and produces a sudden onset of pain, elevation of the testicle within the scrotal sac, rotation of the epididymis from a posterior to an anterior position, and absence of blood flow on Doppler examination or 99m Tc scan. Persistence of symptoms after a course of therapy for epididymitis suggests the possibility of testicular tumor or of. | Chapter 124. Sexually Transmitted Infections Overview and Clinical Approach Part 6 Epididymitis Acute epididymitis almost always unilateral produces pain swelling and tenderness of the epididymis with or without symptoms or signs of urethritis. This condition must be differentiated from testicular torsion tumor and trauma. Torsion a surgical emergency usually occurs in the second or third decade of life and produces a sudden onset of pain elevation of the testicle within the scrotal sac rotation of the epididymis from a posterior to an anterior position and absence of blood flow on Doppler examination or 99mTc scan. Persistence of symptoms after a course of therapy for epididymitis suggests the possibility of testicular tumor or of a chronic granulomatous disease such as tuberculosis. In sexually active men under age 35 acute epididymitis is caused most frequently by C. trachomatis and less commonly by N. gonorrhoeae and is usually associated with overt or subclinical urethritis. Acute epididymitis occurring in older men or following urinary tract instrumentation is usually caused by urinary pathogens. Similarly epididymitis in men who have practiced insertive rectal intercourse is often caused by Enterobacteriaceae. These men usually have no urethritis but do have bacteriuria. Epididymitis Treatment Ceftriaxone 250 mg as a single dose IM followed by doxycycline 100 mg PO twice daily for 10 days constitutes effective treatment for epididymitis caused by N. gonorrhoeae or C. trachomatis. Fluoroquinolones are no longer recommended for treatment of gonorrhea in the United States because of the emergence of resistant strains of N. gonorrhoeae especially but not only among homosexual men Fig. 124-1 . Levofloxacin 500 mg PO once daily for 10 days is also effective for syndrome-based initial treatment of epididymitis when infection with Enterobacteriaceae is suspected however this regimen should probably be combined with effective therapy for possible gonococcal or .

• Y học thường thức
• Sexually Transmitted Infections
• Clinical Approach
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• ABC of sexually transmitted infections
• Main presentations
• Male patients
• Examination techniques
• Genital ulcer disease
• Pelvic inflammatory disease
• Genital growths
• Genital infestations
• Sexual health services
• The sexual health consultation
• Clinical sampling
• Viral hepatitis
• Systemic manifestations
• Sexual health care
• Reproductive tract infections
• Hepatitis B
• Person sexual contact
• Several of these infections
• Tissue transfer
• Illustrated synopsis
• Sexually transmitted diseases
• Adverse drug reactions
• Autoimmune connective tissue diseases
• Cutaneous response
• Bacterial Infections
• Chlamydia trachomatis
• Men Sex Men
• Heterosexual Men
• Mucosal Immunity
• Public health
• Care seeking behavior
• Global public health issue
• Pelvic inflammatory disease
• Ureaplasma urealyticum
• Human papillomavirus
• Mycoplasma genitalium
• Dermatology for the USMLE
• Melanocytic skin disorders
• Malignant skin disorders
• Selected bacterial infections
• Selected fungal infections