What is the leading diagnosis for a 21-year-old male with sudden onset right testicular pain associated with nausea and vomiting?

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Differential Diagnosis for Sudden Onset Testicle Pain

Single most likely diagnosis

  • Testicular torsion: This is the most likely diagnosis due to the sudden onset of severe testicle pain, which is a classic symptom of testicular torsion. The associated nausea and vomiting also support this diagnosis, as they can occur due to the severe pain and potential decreased blood flow to the testicle.

Other Likely diagnoses

  • Epididymitis: This is an inflammation of the epididymis, which can cause testicle pain, nausea, and vomiting. It is often caused by a bacterial infection and can be distinguished from testicular torsion by the presence of urinary symptoms and a more gradual onset of pain.
  • Orchitis: This is an inflammation of the testicle, which can cause pain, swelling, and nausea. It is often caused by a viral infection and can be distinguished from testicular torsion by the presence of fever and a more gradual onset of pain.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

  • Testicular rupture: This is a rare but serious condition that can occur due to trauma to the testicle. It requires immediate surgical attention to prevent further complications.
  • Appendicitis: Although less common, appendicitis can present with testicle pain if the appendix is located near the testicle. It is a surgical emergency that requires prompt attention.

Rare diagnoses

  • Henoch-Schönlein purpura (HSP): This is a rare condition that can cause testicle pain, nausea, and vomiting, along with a characteristic rash. It is often seen in children but can occur in adults.
  • Spermatic cord thrombosis: This is a rare condition that can cause testicle pain and swelling due to a blood clot in the spermatic cord. It requires prompt medical attention to prevent further complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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