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Abstract: A 53-year-old male with swelling and pain in the left testicle for 3 days and fever for 1 day with a maximum fever of 38.6℃ came to our hospital. After passing ultrasound, routine blood and urine tests, he was diagnosed with left-sided epididymitis. After the patient was given drug infusion anti-infection treatment, the patient’s body temperature returned to normal, the symptoms of testicular swelling and pain were significantly reduced, the pain disappeared, and the condition gradually improved.
Basic information】Male, 53 years old
Disease Type】Left-sided epididymitis
Hospital】Zhengzhou First People’s Hospital
Date of Consultation】October 2021
Treatment plan】Intravenous injection (levofloxacin hydrochloride injection) + topical medication (magnesium sulfate)
Treatment Period】10 days of inpatient anti-infection treatment
Treatment effect】The patient’s body temperature was normal, testicular swelling was reduced, pain disappeared, and blood and urine routine were normal on recheck.
I. Initial consultation
One day, a 53-year-old male came to the clinic. The patient complained of swelling and pain in the left testicle since 3 days, and it only hurt when he walked more at first, but it also hurt when he rested for the past 2 days. The patient was given a physical examination: the patient’s left scrotum and testicles were enlarged, there was tenderness, the scrotal skin was red, the pain would not be aggravated by raising the scrotum, the feeling was slightly reduced, the right testicle was normal.
The ultrasound examination was completed: the results showed that the head, body and tail of the left epididymis were enlarged, and rich blood flow signals were seen, so the initial consideration was left epididymitis. The patient denied that he had only been diagnosed with prostatic hyperplasia, and that he had been taking tamsulosin hydrochloride extended-release capsules for prostatic hyperplasia for some time before, and the preliminary diagnosis: left epididymitis and syringomyelia.
II. Treatment history
The patient had no history of drug allergy, so the patient was given levofloxacin hydrochloride injection by intravenous infusion and magnesium sulfate diluted with warm water, and then the scrotum was compressed with a wet towel. The patient was advised to lie down more often, elevate the scrotum, drink more water, do not drink alcohol and do not eat spicy and stimulating food.
Three days later, the blood and urine culture results showed that Escherichia coli infection. The patient’s body temperature dropped at this time, up to 37.5℃, but the left testicle was more swollen than before. The patient’s blood count was 12.73×10^9/L, the neutrophil count was 79.80%, the urine routine was normal, and the patient was given levofloxacin hydrochloride injection anti-infection treatment for 1 week.
III. Treatment effect
The patient was treated with levofloxacin hydrochloride injection infusion for 10 days, and the routine blood and urine tests were repeated, and the white blood cell and neutrophil counts returned to normal, and the blood and urine culture results indicated that no bacterial growth was seen.
IV. Precautions
We are happy that the patient’s symptoms have improved, but we also need to advise the patient that he must rest more and move less after discharge. It is better to continue to lie in bed and elevate the scrotum during rest to promote lymphatic reflux and help recovery, and we should pay attention to not overworking in life, keeping a relaxed mood, avoiding anxiety, strengthening nutrition, eating reasonably, not drinking alcohol and not eating spicy and stimulating food to avoid affecting the recovery.
In addition, you need to continue to take oral medication to treat prostate enlargement and prevent urinary tract infection, which can play a role in preventing the recurrence of epididymitis. Once the symptoms of swollen and painful testicles occur again in daily life, you must go to medical institutions for treatment in time to avoid delaying the disease.
V. Personal insight
The left epididymitis is a common type of epididymitis, and this patient is mostly considered to be related to his prostate enlargement, and the treatment is mainly based on anti-inflammatory, while with wet compresses can accelerate the improvement of the condition and control the symptoms. In addition, it is necessary to remind male compatriots, in daily life, if there is pain in urination, lower abdominal discomfort, urinary suffering, testicular pain and other symptoms, must be timely consultation, improve the relevant examination, clear the cause of symptomatic treatment, to avoid delaying the disease.