Differential Diagnosis for Inflamed and Painful Scrotum
- Single Most Likely Diagnosis
- Epididymitis: This is the most common cause of an inflamed and painful scrotum, especially in young men. It is usually caused by a bacterial infection, often related to a urinary tract infection or a sexually transmitted infection.
- Other Likely Diagnoses
- Orchitis: Inflammation of one or both testicles, often caused by bacterial or viral infections. It can occur alone or in conjunction with epididymitis.
- Testicular torsion (early stages): While not typically the first diagnosis considered for an inflamed scrotum, early stages of testicular torsion can present with inflammation and pain before the classic signs of a high-riding testis and loss of cremasteric reflex.
- Hydrocele: An accumulation of fluid around a testicle, which can cause swelling and discomfort. While not typically painful, it can become inflamed and painful if infected.
- Do Not Miss Diagnoses
- Testicular torsion: A medical emergency that requires immediate attention. Delayed diagnosis can result in loss of the testicle.
- Testicular cancer with secondary infection: Although rare, testicular cancer can become infected, leading to inflammation and pain.
- Fournier's gangrene: A severe and potentially life-threatening condition characterized by necrotizing fasciitis of the genitalia.
- Rare Diagnoses
- Henoch-Schönlein purpura (HSP): A form of vasculitis that can cause scrotal swelling and pain, among other symptoms.
- Sarcoidosis: A systemic disease that can cause granulomatous inflammation in various parts of the body, including the testes and epididymis.
- Tuberculosis epididymitis: A rare cause of epididymitis, especially in areas where tuberculosis is common.