Differential Diagnosis for Epididymitis
- Single most likely diagnosis
- Epididymitis: This is the most likely diagnosis given the presentation, as it is a common condition characterized by inflammation of the epididymis, often caused by bacterial infection, and its symptoms align closely with what is typically observed in cases of epididymitis.
- Other Likely diagnoses
- Orchitis: Inflammation of one or both testicles, which can occur alongside epididymitis (epididymo-orchitis) and presents with similar symptoms such as testicular pain and swelling.
- Testicular torsion: A condition that requires urgent medical attention, characterized by the twisting of the spermatic cord, cutting off the blood supply to the testicle. It presents with sudden, severe testicular pain.
- Hydrocele: An accumulation of fluid in the tunica vaginalis, a potential space around the testicle, which can cause swelling and discomfort but is typically painless.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular cancer: Although less common, testicular cancer can present with a testicular mass or swelling and must be considered to ensure timely diagnosis and treatment.
- Pyocele: An accumulation of pus in the tunica vaginalis, which can be a complication of epididymitis and requires prompt drainage.
- Fournier's gangrene: A severe, life-threatening condition involving necrotizing fasciitis of the genitalia, which, although rare, demands immediate recognition and treatment.
- Rare diagnoses
- Spermatocele: A cystic structure filled with sperm, which is usually asymptomatic but can cause discomfort if large enough.
- Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins, which can cause a feeling of heaviness or discomfort but is typically not painful.
- Tuberculosis epididymitis: A rare form of epididymitis caused by Mycobacterium tuberculosis, which can present with chronic symptoms and weight loss.