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Epididymo-orchitis — SCE Infectious Diseases MCQ

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ModerateSTIsEpididymo-orchitisSCE Infectious Diseases

A 28-year-old man presents with a 3-day history of painful scrotal swelling and urethral discharge. He has sex with women only. NAAT is negative for Chlamydia and Gonorrhoea. Urine culture grows Escherichia coli. What is the most appropriate treatment?

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Correct answer: A — Ofloxacin 200 mg BD for 14 days

In heterosexual men, particularly those >35 years or with urological risk factors, enteric Gram-negative organisms (E. coli) are the most common cause of epididymo-orchitis. A fluoroquinolone with good urinary tract and prostatic penetration (Ofloxacin 200 mg BD for 14 days) is the recommended treatment per BASHH. This differs from sexually acquired epididymo-orchitis in younger MSM where Chlamydia is more common and Doxycycline is preferred.

Reference: BASHH 2020 – Epididymo-orchitis guidelines; NICE CKS 2024