By vgreene, 30 September, 2016 If GC or chlamydia suspected/confirmed, refer sex partners who had contact w/ pt w/in 60 days of sx onset for eval, testing, presumptive tx5
By vgreene, 30 September, 2016 Adjunctive tx: Bed rest, scrotal elevation, NSAIDs until fever/local inflammation subside4
By vgreene, 30 September, 2016 Recommended regimen ceftriaxone 500 mg 1 g if pt wt 150 kg IM x1 doxycycline 100 mg PO bid x10 days
By vgreene, 30 September, 2016 If acute epididymitis1 2 suspected r o spermatic cord testicular torsion use point of care test to eval for inflammation US3 if dx in doubt or torsion suspected treat presumptively based on most likely etiology test all cases for GC chlamydia other STIs
By vgreene, 30 September, 2016 Test all suspected cases for GC chlamydia via urine NAAT 6 test for other STIs incl HIV
By vgreene, 30 September, 2016 Reserve US3 for men w/ scrotal pain who cannot be accurately diagnosed by hx/PE/labs or if torsion suspected
By vgreene, 30 September, 2016 Point-of-care tests for inflammation:5 Gram or methylene blue or gentian violet (MB/GV) stain of urethral secretions demonstrating ≥2 WBC/oil immersion field; positive leukocyte esterase on first-void urine; or micro exam of sediment from spun first-void
By vgreene, 30 September, 2016 Consider testicular torsion4 in all cases though more common in adolescents or if inflammation absent; if severe, sudden unilateral pain, or if test results do not support urethritis/UTI or if dx of epididymitis questionable, refer immediately to urology
