Introduction
Inflammation of the testicles (orchitis) is a rather rare clinical picture that affects boys and men. In most cases the disease is caused by an infection. Via the various structures of the male genitalia – the blood vessels, lymphatic channels, the draining urinary tract or the spermatic duct – germs can enter the testicular tissue and lead to an inflammation there.
Causes
One differentiates between infectious and non-infectious causes of testicular inflammation Infectious causes: Non-infectious causes:
- Mumps
- Varicella (chickenpox)
- Epstein-Barr-Virus (whistling glandular fever)
- Malaria
- Coxsackie viruses
- Brucellen
- Salmonella
- Urinary tract infections
- Sexually transmitted diseases like syphilis
- Epididymitis
- Injuries (traumas)
- Autoimmune reaction
- Medications (e.g. amiodarone)
In most cases testicular inflammation results from mumps disease. Mumps (also known as parotitis epidemica or mumps) is caused by an infection with mumps virus. It is a classic childhood disease, against which most children are now vaccinated as a precautionary measure.
Characteristically, the parotid glands swell strongly at the side of the head and the patients have “hamster cheeks”. The pathogen can enter the bloodstream via the glands and spread to the testicles. This clinical picture is called mumpsorchitis.
Mumpsorchitis only occurs after puberty in sexually mature men. Usually both testicles are affected by the inflammation, but the infection can also be unilateral. There is no effective therapy against mumps.
The treatment of the inflammation of the testicles in case of mumps consists of cooling the testicles and storing them as high as possible. If the testicle is in pain, the doctor can prescribe soothing medication (usually from the group of non-steroidal anti-inflammatory drugs, e.g. ibuprofen). Patients must take it easy and keep strict bed rest.
After about one week to ten days, the symptoms of mumps orchitis disappear. An inflammation of the testicles caused by mumps can have serious complications. The disease can limit the fertility of the affected men.
In some cases, patients are completely infertile (sterility) after the testicle inflammation. For this reason, it is important to protect your children from mumps and its late effects as early as possible. This is possible with a simple vaccination.
Find detailed information on this topic in our main article: MumpsIn addition to mumps, Pfeiffer’s glandular fever (mononucleosis) is one of the most common causes of testicular inflammation. Pfeiffer’s glandular fever is a viral disease caused by the Epstein-Barr virus. It is the initial infection with the virus, which mainly affects adolescents and young adults.
Usually the virus mainly attacks the pharyngeal tonsils and lymph nodes in the body, but the infection can also spread to other organs, including the testicles, via the blood. In addition to fever and a significantly reduced general condition, patients also suffer from greatly enlarged, pressure-sensitive testicles. Here too, the therapy consists of elevating and cooling the scrotum.
If necessary, pain-relieving medication can be administered. The disease usually heals within three weeks. Possible consequences of an inflammation of the testicles as part of an Epstein-Barr virus infection are irreversible damage to the testicles with a reduction in size (testicular atrophy) and infertility.
You can find everything about this topic under: Pfeiffer’s glandular fever wind pox are also called varicella. This is an extremely contagious infectious disease caused by the varicella zoster virus (VZV). Since it mainly affects children, the disease is one of the children’s diseases.
However, adults can also be infected, and the disease usually progresses more severely in them than in younger patients. The viruses cause the typical skin rash (exanthema), which is also called “starry sky” due to its varied appearance. Via the bloodstream, the viruses can also enter the testicles and cause testicular inflammation.
The testicles swell, are sensitive to pressure and hurt. The duration of the disease is about ten days, after which any existing inflammation of the testicles improves.The most effective protection against chickenpox is varicella vaccination, which is recommended for every newborn baby. You can find more information about chickenpox here: ChickenpoxAn inflammation of the testicles can also occur in combination with malaria.
Malaria is a tropical disease transmitted by small parasites called plasmodia. In our latitudes, cases of malaria are rare, mostly it concerns people who have returned from a stay in the tropics or subtropics. Malaria causes flu-like symptoms with fever and a severe feeling of illness.
In rare cases, the pathogens can also enter the testicles via the bloodstream, where they can lead to testicular inflammation. The disease is treated with special malaria drugs, whereby the active ingredient depends on the exact type of pathogen. Many patients develop orchitis as a result of an epididymitis.
Via the lower urinary tract or the prostate, bacteria can ascend via the vas deferens into the epididymis. The most common pathogens causing epididymitis are Escherichia coli, enterococci or staphylococci, whereas viral triggers are much rarer. Epididymitis often occurs after urinary tract infections or the pathogens are sexually transmitted.
If the inflammation spreads from the epididymis to the testicles, this clinical picture is called epididymal orchitis. The symptoms caused by epididymitis and testicular inflammation are very similar. The testicles and epididymis swell strongly, the scrotum is reddened and hurts.
The pain can radiate into the abdomen and is occasionally accompanied by high fever. A combined inflammation of the testicles and epididymis is treated by elevating and cooling the scrotum as well as sufficient bed rest. If the pain is severe, painkillers can be taken.
If the disease has a bacterial cause, the doctor will prescribe antibiotic medication. and By these symptoms I recognize an epididymitisCoxsackie viruses cause a number of different diseases, such as eye infections, the hand-foot-mouth disease or a summer flu. These pathogens can also cause an inflammation of the testicles and epididymis.
Depending on the clinical picture, various symptoms such as headache, bronchitis or fever occur. In case of an inflammation of the testicles caused by Coxsackie virus, the testicles are painfully swollen, the scrotum is reddened and very sensitive. The therapy is symptomatic and is carried out with pain-relieving medication.
In rare cases an infection with Salmonella can cause an inflammation of the testicles. Salmonella are bacteria that usually cause food poisoning (gastrointestinal poisoning, salmonellosis). The affected persons suffer from gushing vomiting and diarrhoea.
The bacteria are mainly absorbed through infected animal foods, such as raw poultry meat, eggs or ice cream, and then lead to the disease. Occasionally the pathogens reach the testicular tissue via the blood and cause an inflammation of the testicles. The therapy of a Salmonella disease consists of a sufficient fluid intake.
Antibiotics are normally not administered as they do not significantly influence the course of the disease. Brucella are bacteria and cause the infectious disease brucellosis. The pathogens are transmitted to humans through infected animals (goats, sheep, pigs or cattle).
In most cases, the disease progresses without symptoms and goes unnoticed by those affected. However, symptoms such as fever, night sweats and chills can also occur. Brucella can also attack the internal organs, with the bones and joints being most commonly affected.
In some cases, brucella cause testicular inflammation. Therapeutically, the testicle is then elevated and cooled. The pathogens are also treated with antibiotic therapy.
An inflammation of the testes can be caused by sexually transmitted diseases such as syphilis (lues). Syphilis is an infectious disease that is transmitted by certain bacteria exclusively by sexual means. More rarely, infection occurs through contact with infected blood. The symptoms of syphilis can vary greatly depending on the stage of the disease, but characteristically a small, painless ulcer initially forms on the penis. In syphilis-associated orchitis, the bacteria enter the testicles via the blood or lymphatic fluid, where they cause a painful inflammation.The treatment is done with antibiotics.
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