Differential Diagnosis for Swollen Testicles with Severe Pain and Indwelling Catheter
- Single most likely diagnosis:
- Epididymitis: This is the most likely diagnosis given the symptoms of swollen testicles and severe pain, especially with the presence of an indwelling catheter, which increases the risk of urinary tract infections (UTIs) that can ascend to the epididymis.
- Other Likely diagnoses:
- Orchitis: Inflammation of one or both testicles, often caused by bacterial or viral infections, which could be related to the indwelling catheter.
- Testicular torsion: Although less likely given the context of an indwelling catheter, testicular torsion is a possible cause of severe testicular pain and swelling.
- Prostatitis: Inflammation of the prostate gland, which could be related to the indwelling catheter and might cause referred pain to the testicles.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Testicular torsion (mentioned earlier, but included here for emphasis): It's crucial not to miss this diagnosis due to its potential for causing irreversible damage to the testicle if not treated promptly.
- Testicular rupture: A severe injury that could lead to significant complications if not addressed immediately.
- Fournier's gangrene: A rare but life-threatening condition involving necrotizing fasciitis of the genitalia, which could be precipitated by an infection related to the indwelling catheter.
- Rare diagnoses:
- Testicular cancer: Although testicular cancer can cause a testicular mass, it typically does not cause acute severe pain and swelling.
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can cause testicular pain and swelling, but it is relatively rare and usually accompanied by other systemic symptoms.
- Spermatic cord thrombosis: A rare condition that could cause testicular pain and swelling due to a blood clot in the spermatic cord.