Scrotal elevation
Analgesia
For acute<unk>  likely caused by STI
Ceftriaxone 250 mg IM in a single dose PLUS
Doxycycline 100 mg orally twice a day for 10 days
Ceftriaxone 250 mg IM in a single dose PLUS
Doxycycline 100 mg orally twice a day for 10 days
For acute<unk>  most likely caused by STI and enteric organisms (MSM)
Ceftriaxone 250 mg IM in a single dose PLUS
Levofloxacin 500 mg orally once a day for 10 days OR
Ofloxacin 300 mg orally twice a day for 10 days
Ceftriaxone 250 mg IM in a single dose PLUS
Levofloxacin 500 mg orally once a day for 10 days OR
Ofloxacin 300 mg orally twice a day for 10 days
For acute<unk>  most likely caused by enteric organisms
Levofloxacin 500 mg orally once daily for 10 days OR
Ofloxacin 300 mg orally twice a day for 10 days
Levofloxacin 500 mg orally once daily for 10 days OR
Ofloxacin 300 mg orally twice a day for 10 days
Treat sexual partner if possible
If med adherence is an issue:
Ceftriaxone 500mg IM once AND
Azithromycin 1 g PO once
Ceftriaxone 500mg IM once AND
Azithromycin 1 g PO once
Rule out testicular torsion
Bed rest to ensure lymphatic drainage
Ice packs, acetaminophen, ibuprofen
Rarely oral narcotics
Pediatric urology follow up outpatient in non-toxic child for possible GU anatomical abnormalities
Antibiotics for 10-14 days, with urine culture sent:
Trimethroprim-sulfamethoxazole
Amoxicillin-clavulanate
Coverage for chlamydia and N. gonorrhoeae in suspected cases of sexual transmission
Avoid fluoroquinolones in pediatric patients
Severely ill or septic children:
First generation cephalosporin AND Aminoglycoside
Trimethroprim-sulfamethoxazole
Amoxicillin-clavulanate
Coverage for chlamydia and N. gonorrhoeae in suspected cases of sexual transmission
Avoid fluoroquinolones in pediatric patients
Severely ill or septic children:
First generation cephalosporin AND Aminoglycoside
First generation cephalosporin AND Aminoglycoside
Epididymitis
Scrotal cellulitis
Traumatic epididymitis
Testicular torsion
Fournier gangrene
Spermatocele
Hematocele
Hydrocele 