MDM - Epididymitis

[##]-year-old male with history and exam consistent with likely epididymitis.

Initial considerations in this patient included epididymitis, testicular torsion, hematocele, hydrocele, spermatocele, hernias, scrotal abscess, sexually transmitted infections, urinary tract infection (UTI), scrotal abscess and cellulitis, Fournier gangrene, and testicular mass or neoplasm among others.  

Patient presented with report of [testicular/scrotal] pain with associated [dysuria/fever/urinary frequency] and pain on palpation of the epididymitis [relieved with elevation of the testicle (Prehn sign)] suggestive of epididymitis.  [A scrotal ultrasound was obtained due to patient report of testicular pain, and was notable for evidence of epididymitis without findings suggestive of torsion.]  A urinalysis was obtained and [noted to be unremarkable/notable for evidence of pyuria consistent with epididymitis].  In addition, urine tests for gonorrhea and chlamydia were sent with discussion of [follow up with primary care doctor for results of these tests/treatment with antibiotics to cover these organisms prophylactically and recommendation that sexual partners are tested].  

Prior to discharge, we discussed return precautions and discharge with antibiotics to cover [sexually transmitted infections/enteric organisms], and the patient demonstrated understanding and agreement with this plan.