- Author: Nataisia Terry, MD; Chief Editor: Erik D Schraga, MD more...
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.
Hippocrates first reported the syndrome in the 5th century BC. Orchitis most commonly occurs with epididymitis. Epididymitis is usually bacterial in origin; the most common pathogen is Neisseria gonorrhoeae in men aged 14-35 years, and Escherichia coli is the most common cause in boys younger than 14 years and in men older than 35 years. Viral orchitis is most often caused by mumps infection but can also be caused by a nonspecific inflammatory process in the testes.
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. The symptoms of orchitis usually present several days after parotitis. Isolated bacterial orchitis is even more rare and is usually associated with a concurrent epididymitis.
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.
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).
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