Treatment of Epididymo-Orchitis with Risk Factors for Gonorrhoea
This protocol addresses inflammatory disease of the spermatic cord, tunica vaginalis, and vas deferens in patients presenting with epididymo-orchitis where a sexually transmitted infection is suspected and gonorrhoea is considered likely based on clinical risk factors.
Clinical Scenario — Gonorrhoea Risk Factors Present
One or more of the following risk factors for gonorrhoea is identified in this patient:
- Purulent urethral discharge
- Known contact of a gonorrhoeal infection
- Men who have sex with men
- Black ethnicity
Treatment Approach
The protocol specifies a combination antibiotic regimen incorporating an intramuscular injection alongside an oral antibiotic course — with an additional oral agent indicated when gonorrhoea is considered likely. Complete drug selection, dosing, and duration are available in the full structured protocol.
Clinical Goals
- Improvement in scrotal pain and swelling by day 3
- Full resolution of symptoms at 2 weeks
- Negative N. gonorrhoeae culture 3 days after completing treatment
References
DOI: 10.1177/0956462417699356
Ceftriaxone 500 mg intramuscular injection IIIB PLUS Doxycycline 100 mg twice daily for 10–14 days IIIB
In patients where gonorrhoea is considered likely (see risk factors above) azithromycin should be added to ceftriaxone and doxycycline to provide optimal antibiotic cover.
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