Bacterial Epididymitis

Bacterial epididymitis:


  • Testicular pain/tenderness
  • Unilateral testicular swelling
  • Fever/chills
  • Urinary urgency, frequency, and/or pain with urination


  • Bacterial from a urinary tract infection
    • Likely the cause in men over the age of 35 and whom are a low risk for STIs.
  • Trauma
  • Autoimmune Diseases
  • Sexually transmitted infections (STIs)
    • STIs: gonorrhea or trichomoniasis are common causes of epididymitis in men under the age of 35 year old.
      • Risk factors: sexual relations outside of a monogamous relationship.
      • Men who practice insertive anal intercourse.

How it is diagnosed:

  • History and physical exam
  • Scrotal ultrasound: will reveal epididymitis and/or other abnormalities (not all cases require an ultrasound for diagnosis)
  • Urinalysis may be abnormal/appear infected


  • Antibiotics, symptoms should start to improve in 48-72 hrs after beginning antibiotics
    • Typically treated with oral antibiotics for ~10days
      • If patient is seriously ill may require hospitalization and IV antibiotics
  • Good scrotal support
  • Anti-inflammatory such as ibuprofen 600 mg 3 times daily or naproxen 220 mg twice daily taken with food or a proton pump inhibitor to help prevent GI upset or the possibility of GI ulcer/bleed. Treatment course 7 to 14-days depending on the severity of symptoms
  • Ice and elevation,
    • For ice 10-15 minutes a few times per day for 1-2 days

If your symptoms to not improve, please contact your healthcare provider for further evaluation.
Please do not hesitate to contact our office with questions or concerns.

Reference: Eyre, R.C. (2020). Evaluation of Acute Scrotal Pain in Adults. In M.P. O’Learly (Eds.), UpToDate. Retrieved March 27, 2020.