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- result of descending infection caused by urinary tract pathogens
- When the infection involves the epididymis and testis (epididymo-orchitis), sonography will frequently show an
enlarged heterogeneous testis with increased color flow.
- In sexually active men under age 35, acute epididymitis is caused most frequently by Chlamydia trachomatis and less commonly by Neisseria gonorrhoeae.
- Clinical features suggestive of urethritis may be absent (subclinical urethritis). Epididymitis in men who have practiced unprotected insertive rectal intercourse is often caused by Enterobacteriaceae.
- These men usually do not have urethritis but do have bacteriuria. Treatment of acute epididymo-orchitis consists of administering appropriate antibiotics for the treatment of both gonorrhea and Chlamydia infections.
- Unilateral absent flow on color and spectral Doppler sonography is a highly sensitive and specific finding
- Heterogeneous echotexture of the testis is a common finding in sonograms performed to evaluate acute scrotal pain, regardless of the cause.
- emergent urology referral is indicated
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