Introduction
An inflammation of the testicles, also called orchitis, is in the majority of cases caused by bacteria or viruses. Almost always an inflammation of the testes is accompanied by an inflammation of the epididymis. The clinical picture is then called epidymorchitis.
An inflammation of the testes usually occurs unilaterally, pain can be of varying intensity. However, swelling and general symptoms of a viral or bacterial infection are obligatory. This topic might also be of interest to you: What are the causes of testicular inflammation?
Causes of inflamed testicles
The cause of inflammation of the testes is usually viruses, such as paramyxoviruses, which also cause mumps disease. Most often, testicular inflammation occurs in the course of mumps disease, typically 4-7 days after the inflammation of the parotid gland. However, varicella viruses, coxsackie viruses, and echo viruses can also cause orchitis.
They enter the testicles via the bloodstream and spread there. Varicella is well known to us, it belongs to the herpes virus family and causes chickenpox, usually in childhood. Pfeiffer’s glandular fever and the Ebstein Barr Virus (EBV, or infectious mononucleosis) can also cause inflammation of the testicles.
The infections mentioned above are viral infections caused by viruses. Of course, orchitis can also have bacterial causes: The bacteria usually spread upwards via the urinary and seminal tracts, and thus reach the testicles. Due to the anatomical proximity, the epididymis is then almost always affected.
The pathogen spectrum of orchitis is similar to that of a common urinary tract infection. It ranges from Chlamydia, Neisseria, Klebsiellen, Pseudomonas, to Staphylococcus, Streptococcus, E. coli bacteria and Brucella. Some known diseases that can also be caused by these pathogens are gonorrhoeae and syphilis.
In principle, sexually active men are more often affected by an inflammation of the testicles, as the triggering factor can often be sexually transmitted diseases such as those mentioned above. However, an orchitis does not always have to be primarily caused by viruses or bacteria, and external injuries – i.e. trauma – can also open an entrance portal for pathogens that then colonize the wound. Epididymitis can also spread to the testicles, as both are very close to each other and have a large contact surface.