Orchitis

Author: Mark B Mycyk, MD; Chief Editor: Erik D Schraga, MD more...

Updated: May 5, 2010

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Background
Pathophysiology
Epidemiology
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Background

Orchitis is an acute inflammatory reaction of the testis secondary to infection. Most cases are associated with a viral mumps infection; however, other viruses and bacteria can cause orchitis.

Pathophysiology

Hippocrates first reported the syndrome in the 5th century BC. While the more common epididymo-orchitis is bacterial in origin, isolated orchitis usually has a viral etiology.

Frequency

United States

Approximately 20% of prepubertal patients with mumps develop orchitis. This condition has become increasingly common in adolescent and postpubertal males with mumps, especially in the last decade with a reduction in use of the measles, mumps, rubella (MMR) vaccine. Isolated bacterial orchitis is even more rare and is usually associated with a concurrent epididymitis.

Mortality/Morbidity

Unilateral testicular atrophy occurs in 60% of patients with orchitis.
Sterility is rarely a consequence of unilateral orchitis.
Despite some anecdotal reports, little evidence supports an increased likelihood of developing a testicular tumor after an episode of orchitis.

Age

In mumps orchitis, 4 out of 5 cases occur in prepubertal males (younger than 10 years).
In bacterial orchitis, most cases are associated with epididymitis (epididymo-orchitis), and they occur in sexually active males older than 15 years or in men older than 50 years with benign prostatic hypertrophy (BPH).

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Mark B Mycyk, MD Associate Professor, Department of Emergency Medicine, Boston University School of Medicine

Mark B Mycyk, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Eric M Kardon, MD, FACEP Attending Emergency Physician, Georgia Emergency Medicine Specialists; Physician, Division of Emergency Medicine, Athens Regional Medical Center

Eric M Kardon, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Richard H Sinert, DO Associate Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

References

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