Orchitis Clinical Presentation

Updated: Jan 26, 2023
  • Author: Nataisia Terry, MD; Chief Editor: Erik D Schraga, MD  more...
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Orchitis is characterized by testicular pain and swelling. The course is variable and ranges from mild discomfort to severe pain.

Associated systemic symptoms include the following:

  • Fatigue

  • Malaise

  • Myalgias

  • Fever and chills

  • Nausea

  • Headache

Mumps orchitis follows the development of parotitis by 4-7 days. Obtain a sexual history, when appropriate.

Epididymitis also occurs in most cases of mumps orchitis and results in epididymo-orchitis. [20]

In a study by Tae et al, the clinical manifestations of mumps orchitis in 62 postpubertal vaccinated patients included a mean incubation period of 5.39 days (range, 0 to 23 days), a febrile duration of 1.8 days (range, 0.5 to 3 days), and a mean duration of orchitis of 4.96 days (range, 0 to 17 days). Sonography revealed unilateral orchitis in 58 patients (93.6%) and bilateral orchitis in 6 (6.4%). The mean age of the 62 patients was 17.56 years (range, 15 to 29 years). [6]


Physical Examination

Testicular examination reveals the following:

  • Testicular enlargement

  • Induration of the testis

  • Tenderness

  • Erythematous scrotal skin

  • Edematous scrotal skin

  • Enlarged epididymis associated with epididymo-orchitis

On rectal examination, there is a soft, boggy prostate (prostatitis), often associated with epididymo-orchitis. Mumps orchitis presents unilaterally in 70% of cases. In 30% of cases, contralateral testicular involvement follows by 1-9 days. Other findings include parotitis and fever