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EPIDIDYMITIS

Conditions where contact tracing should be considered: The results of STI testing are generally not available at the initial visit, and a sexually transmitted pathogen is often not found. Contact tracing is always recommended when an STI pathogen is detected and even when it is not, pathogens are sometimes identified in partners. Please refer to the notes relating to that specific pathogen.

 

Causative organisms

Coliforms

Chlamydia trachomatis, Neisseria gonorrhoeae,

Note: Sexually transmissible causes are more likely in younger men (<35 years), and while urinary tract pathogens such as coliforms are increasingly likely in older men (>35 years), STI should be considered in all age groups.

A pathogen is often not identifiable

Incubation period Poorly defined, probably days to weeks depending on the organism
How far back to trace See relevant sections if chlamydia or gonorrhoea are isolated
Usual testing method Clinical diagnosis may be reinforced by detection of urethritis on gram stain chlamydia and gonorrhoea nucleic acid amplification testing and urine microscopy and culture
Common symptoms Scrotal pain, swelling and erythema occasionally associated with dysuria and urethral discharge
Likelihood of transmission per act of unprotected intercourse Depends on specific pathogen
Likelihood of long-term sexual partner being infected Depends on specific pathogen
Protective effect of condoms High for sexually transmitted pathogens
Transmission by oral sex Relevant for/V. gonorrhoeae
Duration of potential infectivity Depends on specific pathogen
Important sequelae If untreated, gonococcal abscess formation; some evidence for decreased fertility
Direct benefit of detection and treatment of contacts Cure where a pathogen is found

Usual management of

contacts

Counselling, clinical examination, test for C.trachomatis and N.gonorrhoeae
  Consider (presumptively treating) sexual contacts and for gonorrhoea if suspected (see STI guidelines)
Contact tracing priority

High - Where C. trachomatis or N. gonorrhoeae isolated

Medium - Younger men and their current sexual partners where a sexually transmitted pathogen is not isolated

Low - Older men and their previous sexual partners, where a sexually transmitted pathogen is not isolated

None - Where a urinary tract pathogen is isolated

Notification Not notifiable

 

 

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