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GU 2 - Scrotal Infections (Kanzler's Worksheet)

Terms in this set (19)

Define epididymitis.
Ascending LUT infection.
What causes epididymitis in the male under 35 years old?
GC/Chlmaydia
What causes epididymitis in the child or older male?
Ecoli
What causes epididymitis in someone having anal sex?
Ecoli or Coliform
What are some clinical features of epididymitis and orchitis?
Gradual onset of:
Urethritis
Cystitis
Prostatitis
What might you find on PE of epididymitis?
Exquisitely tender epididymitis
Possible scrotal erythema
Prehn Sign (+)
Difficulty differentiating epididymis and testicle torsion
What diagnostics are done for epididymitis and orchitis?
UA - R/O UTI, GC and Chlamydia
Scrotal Doppler US - R/O torsion, enlarged epididymis
What is the TX for epididymitis and orchitis?
ABX:
Gonococcal - Ceftriaxone
Chlamydia - Azithromycin or Doxy
Other pathogens - Flouroquinalones or TMP/SMX
Anti-Inflammatories - NSAIDS
Non-Pharm - Scrotal elevation, support, ice
epididymitis
Define orchitis.
epididymitis infection spread to the testes
What causes orchitis in children?
Viral (mumps)
What might you find on PE of orchitis?
Difficult to differentiate between epididymitis and testicle
Per the CDC, orchitis __________ causes infertility.
Rarely
What is another name for Fournier's Gangrene?
Necrotising fascititis
Define Fournier's Gangrene.
Gangrenous bacterial infection of genital soft tissue.
What might you find on PE of Fournier's Gangrene?
Advancing erythema
Scrotal edema
Bleb formation
Foul-smelling discharge
Necrotic tissue
Crepitus: spongy, cracking feeling on palpation - indicating gas-producing organism (anaerobic)
What are some diagnostics for Fournier's Gangrene?
UA
Tissue & Blood Cultures
CBC: ↑ WBC
CMP: Creatinine, BUN, Lytes
ABG's
Coagulation Studies
What is the TX for Fournier's Gangrene?
Broad Spectrum Antibiotics
Urgent & Repeated Surgical Debridement
Metabolic Stabilization

CONSULT!!!!!!
Fournier's Gangrene has an extremely high __________ ______________.
Mortality rate
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