When epididymo-orchitis is complicated by a confirmed Mycoplasma genitalium infection, the management of the underlying inflammatory disease of the spermatic cord, tunica vaginalis, and vas deferens (ICD-10 N49.8 / ICD-11 GB07.Y) requires a specific, organism-directed approach rather than empirical broad-spectrum therapy.
This protocol applies to patients with epididymo-orchitis in whom Mycoplasma genitalium has been identified on testing. The identification of the organism on a genital specimen allows treatment to be guided specifically toward eradicating the confirmed pathogen.
When M. genitalium is confirmed, treatment should include a targeted antibiotic selected for activity against this organism — the complete regimen, including the specific agent and its use in this context, is set out in the full protocol.
Clinical goal: Improvement in symptoms at three days. If no improvement is observed by that point, clinical review and reassessment of the diagnosis are required.
DOI: 10.1177/0956462417699356
Where M. genitalium testing has been performed, and the organism identified, treatment should be guided to include an appropriate antibiotic (e.g. moxifloxacin 400 mg once daily for 14 days) IVC.
At three days if there is no improvement in symptoms, the patient should be seen for clinical review and the diagnosis should be reassessed.
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