Case of chronic hydrocoele with prostate enlargement with orchitis

A 64 year old male presented to clinic with complaints of right scrotal swelling accompanied with fever and pain Chief Complaints He adds that he has been having swelling for a long time, but it is only this time that it has progressed so much with pain and he also had an episode of hematuria and dysuria few days back History He had been under treatment for prostatomegaly as his prostate volume was high and PVRU significant as per his USG KUB Vitals Vitals are normal, but he gets fever almost everyday around 100 to 101 F Investigations USG scrotum report is attached Patient has a USG KUB which revelaed prostatomegaly He is unwilling to undergo further tests which I advised like CBC, and Urine R,M,CS Management Meanwhile, I have started him on following - Oflox 100ml IV BD, Ceftriaxone 1gm IV BD, Tab Ultracet HS, Tab Dolopar 500 if fever more than 100 F Chymoral forte TDS Analgesia of choice in such cases? Antibiotic of choice in such cases? Kindly give your opinion on this case for diagnosis and line of management 🙏 I am suspecting it as a case of secondary hydrocoele due to Orchitis

(Edited)

1 Like

LikeAnswersShare

Pt is having enlarged prostate with high post void residual urine volume suggestive of obstructive pathology due to enlarged prostate. Due to obstruction there is stanation of urine leading to urinary tract infection and recurrent . As there is obstructive pathology leading to recurrent infection due to enlarged prostate needs to be treated first. Culture sensitivity of urine and infection to be controlled by proper antibiotic then to go for treatment of root of obstructive pathology that is enlarged prostate by TURP after going for PSA Rt sided chronic hydrocele is secondary to filarial orchitis and long standing anad recent pain and fever may be due to recurrent filarial orchitis may be with secondary infection Treat in the line of filarial epididymo orchitis then if necessary go for eversion of sac under cover with anti filarial.

Valuable opinion
0

View 2 other replies

It is a case of Bilateral epididymo orchitis in a case of long standing right sided hydrocele Treatment is on right track. He needs antibiotics for at least 2 weeks after 5 days switch over to oral antibiotics Continue tab chymoral forte × 6 hourly for 2 weeks. Also get urine for culture and sensitivity as UTI is one of the causes of associated epididymo- orchitis . Once infection is settled Get him operated for right sided hydrocele

Valuable opinion
0

View 3 other replies

Right sided hydrocoele with right orchitis There is a possibility that her might have developed infection of hydrocoele to form pyocoele. Adv Treat with antibiotics If patient do not respond to treatment then drainage of right sided hydrocoele/ pyocoele may be considered

Valuable opinion
0

View 1 other reply

GERIATRIC CASE WITH.. PROSTATOMEGALY..LEADING TO.. ORCHITIS AND ..SECONDARY..HYDROCELE.. INITIALLY..CONSERVATIVE TREATMENT WITH.. LINEZOLID +CEFIXIME..WITH.. NSAIDS..AS PER REQUIREMENT.. SURGICAL INTERVENTION WITH .. SURGEONS OPINION..

Tnx Dr Krishan kumar Sharma..
0

View 1 other reply

PT have prostomegaly prostitue resulting orchitis and sec hydroce PT need cul n sensitivety of urine Ur conservative TT is all right also advise scrotal support See if pyocele is there or not U can consider meropen the antibiotic in prefence Use akaliser If frequency mict is there Use urispas/mirabact Analgesic antipyretic as u like

Valuable opinion
0

The reports suggesr ?resolving lt epididymorchitis and rt funiculitis. From the history however the patient had no complaints on the left side. The fever could be due to the funiculitis/ orchitis. In the presence of orchitis or funiculitis, it is useful to eliminate 1. UTI and 2.Filariasis. It is often difficult to rule out filariasis .Hence ffort should be made to rule out UTI. Can give a therapeutic trial with hetrazan 100mg thrice a day and do a peripheral smear for microfilariae. If the patient responds to the hetrazan while you wait to start antibiotics for uti and if patient improves, it is filarial.If he does not then it is uti. The flip side is both can coexist.so you may have to treat for both filariasis and uti at the saame time and wait for c/s report.

Valuable opinion
0

View 6 other replies

Medical management with antibiotics and antiinflammatories. Follow up sonography. Sos surgical intervention.

Valuable opinion
0

Ryan chronic hydrocoel With orchitis Ad hydrocoel fluid for HPE If non malignant report comes can treat conservatively Prostatectomy is advocated at this age

Valuable opinion
0

Chronic hydrocele with orchitis

Valuable opinion
0

Acute epididymo-orchitis (AEO) is an acute inflammatory disease of the epididymis and ipsilateral testis. Treatment should be started immediately after diagnosis and includes antibiotics, analgesics, and, if necessary, surgery.

Load more answers

Diseases Related to Discussion

Cases that would interest you