? epidiymitis

  My 4 yr old grandson, awoke with pain in the groin area and testiclar area
  Right testis was reddened and painful.. Notice he was limping, unpon questioning
  admitted pain.  Took him to Peds. for evaluation, they did ultrasound and instructed to observe
  area until seen in Peds in 5 days... Felt it was not twisted, and surgery not needed, sent him home with tylenol for pain
  and instructed to see peds urology.. What causes a healthy 4 yrs old to develop epidiymitis? He has no mumps urethritis t.b and will this continure to be a problem?
  Does he need antibiotic, if it is an inflamation (inflammation) of the epididymis? Thanks information is appreciated
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Dear Jay,
There are different reasons for scrotal pain and swelling. These include: torsion of spermatic cord, torsion of appendages of testicle or epidididymoorchitis. Further causes, such as mumps, orchitis  or even testicular tumors, should  be included. These can be diagnosed by physical exam, ultrasound and labaratory tests.  Torsion of the spermatic cord is the most serious cause, since, if not taken care of right away surgically, it could lead to loss of the involved testicle.  Given the evaluation that was done by your pediatrician, your grandson most likely was O.K., but an evaluation by a urologist would be quite appropriate, too.  
As for your question about epididymitis, it is not as common in children as in adults, but anywhere from 8% to 40% of sudden scrotal swelling could be due to epididymitis. It is more common in uncircumcised boys with urinary tract infections or children with some structural abnormality. Treatment with antibiotics should be provided on the basis of urine cultures and sensitivities. Antiinflammatory pain medications are also a useful adjunct. It is a good idea to foliow -up with a urologist for an evaluation, and in the case of any recurrence of the pain.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: testicular pain/ epididymitis

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A related discussion, dead/painful left testicle related to spinal stenosis? was started.