Epididymitis: The Daily PANCE Blueprint
Which of the following is the most common causative organism of acute epididymitis in older males?
A. Chlamydia trachomatis
B. Neisseria gonorrhoeae
C. Escherichia coli
D. Treponema pallidum
E. Mycoplasma genitalium
Answer and topic summary
The answer is C. Escherichia coli
Acute epididymitis is a condition characterized by inflammation of the epididymis, usually caused by bacteria. N. gonorrhoeae and C. trachomatis are the most common cause in men less than 35 years old. In older men, E. Coli and Pseudomonas are more common. Clinical features include swelling of the affected epididymis and testicular pain with tenderness. Scrotal US with Doppler may need to be ordered to rule out torsion. For younger men, a UA, urine culture, and urine NAAT for N. gonorrhoeae and C. trachomatis should be ordered. Treatment is Bactrim or levofloxacin x 10 days for those not at risk for STIs. For those at risk for STIs, ceftriaxone IM x 1 plus doxycycline x 10 days is preferred.
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