Acute painful unilateral scrotum.
Granulomatous epididymitis is not uncommon after BCG (a treatment for bladder cancer) and can get worse with each treatment.
Do a urine culture for diagnosis and STD evaluation (C. trachomatis and for N. gonorrhoeae by NAAT).
Any age (usually < 35): C. trachomatis and N. gonorrhoeae (I always assume that people over age 35 (being > 50 I will neither confirm nor deny that bias) do not have sex, although the oldest clap I have seen was an 85 yo male. But that was in L.A. And what to do if your age is exactly 35 remains a mystery).
Chronic infectious epididymitis is most frequently Mycobacterium tuberculosis.
Ceftriaxone 250 mg IM in a single dose .
Doxycycline 100 mg orally twice a day for 10 days .
For acute epididymitis most likely caused by sexually-transmitted chlamydia and gonorrhea and enteric organisms (men who practice insertive anal sex).
Ceftriaxone 250 mg IM in a single dose.
Last Update: 07/07/18.