Editing Infections: Orchitis, & Epididymitis (section)

===Diagnosis and Evaluation===
*'''Acute infectious orchitis'''
**'''History: recent onset of testicular pain, often associated with abdominal discomfort, nausea, and vomiting.''' These symptoms may be preceded by symptoms of parotitis in boys or young men, by UTIs in boys or elderly men, or alternatively by symptoms of a sexually transmitted disease in sexually active men.
**'''Physical exam''' may reveal a toxic and febrile patient
*Acute non-infectious orchitis
**Similar presentation to acute infectious orchitis except that these patients lack the toxic appearance and fever
**In the young patient, the most important differential diagnosis is torsion of the testis
*Chronic orchitis and orchialgia
**May have a history of previous episodes of testicular pain, usually secondary to acute bacterial orchitis, trauma, or other causes.
**The scrotum is not usually erythematous, but the testis may be somewhat indurated and is almost always tender to palpation.
*Labs
**Urinalysis, urine microscopy, and urine culture
**When a sexually transmitted disease is suspected, a urethral swab should be taken for culture
*Imaging
**If the diagnosis is not evident from the history, physical examination, and these simple tests, scrotal ultrasonography should be performed (to rule out malignancy in patients with chronic orchitis or orchialgia).
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