Clinical features

• Pain and swelling of the epididymides and / or testes, sometimes with urethral discharge and / or symptoms of UTI 
• For patients under 35y, a sexually-transmitted pathogen is most likely
• Older patients are more likely to be affected by enteric organisms

Investigation

• Urine culture
• First void urine for gonorrhoea and chlamydia PCR

Refer to Sexual Health if there is any concern about sexually-transmitted infection

Infection Control

Basic universal precautions

Treatment

35 yrs or under:

DOXYCYCLINE PO 100 mg 12 hourly

Duration: 14 days

Over 35 yrs or allergic to doxycycline:

OFLOXACIN PO 200mg 12 hourly (review MHRA Safety Advice before prescribing)

Duration: 14 days

OR

CIPROFLOXACIN PO 500mg 12 hourly (review MHRA Safety Advice before prescribing)

Duration 10 days