USMLE® Step 1 style questions USMLE
A 20-year-old man comes to his primary care physician for evaluation of scrotal fullness of several weeks duration.The patient endorses an associated dull, achy pain in his scrotum when standing for prolonged periods that is relieved with lying flat. There are no acute episodes of sudden pain. He has no significant past medical history. Vitals are within normal limits. Physical examination reveals a left-sided scrotal mass that feels like a “bag of worms'' and decompresses with recumbency. The right scrotum is unremarkable. The scrotum does not transilluminate. Which of the following is the most likely complication of this patient's disease if left untreated?
Orchitis is an inflammation of the testes, usually caused by an infection, such as with mumps virus or with sexually transmitted infections. People with orchitis may present with testicular enlargement, pain, tenderness, and swelling. They can also have systemic symptoms like fever, headache, and myalgias. Diagnosis is clinical, but an ultrasound must be done to rule out other causes of acute scrotum such as testicular torsion. Treatment involves symptom relief with analgesics, and antibiotics if a bacterial infection is identified.