Orchitis

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KEY POINTS

• Orchitis is swelling and redness (inflammation) of one or both testicles. The testicles are part of the male reproductive organs.
• Treatment may include rest and elevation of the scrotum if the infection is from a virus like the one that causes mumps. Or your child’s healthcare provider may prescribe an antibiotic if your child’s orchitis is caused by bacteria.
• Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your healthcare provider what symptoms you should watch for and what to do if your child has them.

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What is orchitis?

Orchitis is swelling and redness (inflammation) of one or both testicles. The testicles are part of the male reproductive organs. They are in a sac of loose skin, called the scrotum, which is below and behind the penis. The testicles make sperm and the male hormone, testosterone.

The tube that stores and carries sperm from the testicles to the penis can also be swollen and irritated. This is called epididymitis and may happen along with orchitis.

What is the cause?

Orchitis in children may be seen 4 to 7 days after the child has had mumps. Additionally, orchitis may be caused by infections, blockages, and inflammation from:

• Urinary tract infections
• Blockages in your child’s urinary tract that he was born with
• A sexually transmitted disease or infection (also called an STD or STI) such as chlamydia or gonorrhea

Sometimes no cause can be found.

What are the symptoms?

Symptoms may include:

• Pain in one or both testicles that comes on slowly
• Red, warm, swollen scrotum
• Pain with urination
• Fever and chills
• Nausea
• Feeling very tired
• Headache

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine him. Tests may include:

• Ultrasound, which uses sound waves to show detailed pictures of the testicles
• Urine tests
• Tests for chlamydia and gonorrhea
• Blood tests

How is it treated?

If your child’s orchitis is caused by a viral infection such as the virus that causes mumps, it should get better in a few days. If it is caused by a bacterial infection, your child’s healthcare provider may prescribe antibiotic medicine.

• Give your child nonprescription medicine, such as acetaminophen, ibuprofen, or naproxen to treat pain. Read the label carefully and give your child the correct dose as directed.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
  • Acetaminophen may cause liver damage or other problems. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.

How can I take care of my child?

• Follow the full course of treatment prescribed by your child’s healthcare provider. If your child was prescribed an antibiotic medicine, have him take the antibiotics for as long as your child’s healthcare provider prescribes, even if he feels better. If he stops taking the medicine too soon, he may get sick again. If your child has side effects from the medicine, talk to your child’s healthcare provider.
• Ask your child’s provider:
  • How and when you will get your child’s test results
  • How long it will take to recover
  • If there are activities your child should avoid and when he can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them
• Make sure you know when your child should come back for a checkup.
• If your child is very uncomfortable, he may need to rest in bed for a couple of days.
• Raise his scrotum by putting a rolled-up towel under it when he is resting.
• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the scrotum every 3 to 4 hours for up to 20 minutes at a time, but not longer than 20 minutes. Never put ice directly on the scrotum.
• Take care of your child’s health. He should try to get at least 7 to 9 hours of sleep each night, eat a healthy diet, and try to keep a healthy weight. Help him stay physically active as advised by his provider.

How can I help prevent orchitis?

Children should have the first measles, mumps, and rubella (MMR) shot when they are 12 to 15 months old and the second when they are 4 to 6 years old. Teens and adult males who get mumps can have problems with one or both testicles. In rare case, this can cause sterility.