presented on September 3, 2007

Introduction: Acute epididymitis is one of the most common etiologies of acute scrotum and especially has clinical significance in children. However, it has only been known that its etiology in children is different in organisms to that in adult. So, we investigated prospectively some organisms supposed to be concerned to the etiology of acute epididymitis through the clinical features and additional laboratory data in children and adults.

Methods: A total of 44 patients with acute epididymitis were enrolled in this study and divided into 2 groups, (1) children group; 21 patients 6 to 14 years (mean age 9.68±2.42) and (2) adult group; 23 patients 15 to 78 years (mean age 37±17.83). Scrotal Doppler ultrasonogram, microbiological tests of urine for bacteriuria, throat culture for mumps virus, urethral swab for Chlamydia trachomatis, and serologic tests for Chlamydia trachomatis, adenovirus were performed on admission.

Results: All 44 patients had scrotal pain and tenderness as well as scrotal swelling except one child. There were epididymal swelling and increased blood flow on all scrotal ultrasonograms except one child without scrotal swelling. Only two patients (9.5%) in children and 6 patients (26.1%) in adults had mild fever over 37.5°C on admission. 2 patients (9.5%) in children and 7 patients (30.4%) in adult had leukocytosis (WBC›10x10³/ml). Pyuria (WBC›5/HPF) were found in none of children and 10 patients (43.4%) of adult (p value 0.001). There were positive urine culture in 3 patients of children and one patient of adult. There were chlamydia trachomatis positive in none of children and 10 patients (43.4%) of adult (p value 0.022). Increased adenovirus titers were found only in 9 adult patients (40.9%). Mumps virus tests were all negative in urine and throat of patients.

Conclusions: There was no difference in clinical features and sonographical findings of the scrotum between children and adult groups. In adults, there were significantly more pyuria and Chlamydia positive in comparison with children, which suspect the possibility of sexually tansmitted epididymitis. In children, however, bacteriuria, adeno-virus and mumps virus have the least possibility as an etiologic organisms of acute epididymitis. So, in adults, administration of some drugs for sexually transmitted disease has a rationale but in children any antibiotics is not indicated for acute epididymitis.

Authors: Jung H, Cho J, Cho S, Lee Y

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