Differential Diagnosis for Testicular Swelling and Pain in an Unvaccinated Patient
- Single Most Likely Diagnosis
- Epididymitis: This is the most likely diagnosis due to the patient's unvaccinated status, which increases the risk of sexually transmitted infections (STIs) such as chlamydia and gonorrhea, common causes of epididymitis. The symptoms of testicular swelling and pain are consistent with this condition.
- Other Likely Diagnoses
- Orchitis: Often associated with epididymitis, orchitis (inflammation of the testis) can also be caused by viral infections, which might be more common in unvaccinated individuals. The symptoms can overlap with epididymitis, making it a likely consideration.
- Testicular torsion: Although not directly related to vaccination status, testicular torsion is a medical emergency that presents with sudden onset of testicular pain and swelling. It's essential to consider this diagnosis due to its urgent nature.
- Do Not Miss Diagnoses
- Testicular cancer: While less common, testicular cancer can present with a painless testicular mass or swelling. Given the potential for devastating outcomes if missed, it's crucial to include this in the differential diagnosis.
- Pyocele or testicular abscess: These conditions can arise from untreated epididymitis or orchitis and can lead to severe complications if not addressed promptly.
- Rare Diagnoses
- Henoch-Schönlein purpura (HSP): A systemic vasculitis that can rarely cause testicular swelling and pain. It's more common in children but can occur in adults.
- Sarcoidosis: A condition that can affect multiple organs, including the testes, leading to swelling and pain. It's relatively rare and would be considered after more common causes are ruled out.