title: Acute epididymitis in boys: evidence of a post-infectious etiology.
abstract: OBJECTIVE
  We studied the etiology and management of pediatric epididymitis.
  
  
  METHODS
  We performed 1-year prospective study in children with epididymitis. All patients underwent an immediate sonographic study of the scrotum. Microbiological studies included throat and urine cultures as well as viral cultures of nasopharyngeal and stool specimens. Serological tests for group A streptococcus and Mycoplasma pneumoniae as well as for enteroviruses, adenoviruses, influenza and parainfluenza viruses in the appropriate seasons were performed in patients and controls.
  
  
  RESULTS
  A total of 44 patients 2 to 14 years old (mean age 9.8 +/- 3.2) were studied. Hospital admissions peaked during the summer and winter. The incidence of epididymitis was around 1.2/1,000 boys yearly. One patient had familial Mediterranean fever and another had Henoch-Schonlein purpura. Microbiological studies of the urine, throat, nasopharynx and stool yielded bacterial/viral growth in 9 patients (20.4%). Serological studies revealed significantly elevated titers to certain pathogens in patients with epididymitis compared with controls, including M. pneumoniae (53% vs 20%), enteroviruses (62.5% vs 10%) and adenoviruses (20% vs 0%). Most patients were treated with analgesics and 3 patients received antibiotics intravenously. Systemic and local signs and symptoms resolved gradually in 1 to 7 days.
  
  
  CONCLUSIONS
  Our results suggest that epididymitis in boys is not rare and it is mostly an inflammatory phenomenon (presumably post-infectious) with a benign course. The treatment of these patients is basically with analgesics with a little role for antibiotics.
authors.affiliation: Pediatric Infectious Diseaes Unit, Edith Wolfson Medical Center, Holon, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Somekh
authors.forename: Arkadi
authors.initials: A
authors.lastname: Gorenstein
authors.forename: Francis
authors.initials: F
authors.lastname: Serour
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004823:Epididymitis / Q000175:diagnosis / Q000382:microbiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies