Etiology, Manifestations and Therapy of Acute Epididymitis: Prospective Study of 50 Cases

Abstract

Patients (50) with acute epididymitis were evaluated prospectively by history, examination and microbiologic studies, including cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. Escherichia coli was the predominant pathogen isolated from the urine of men more than 35 yr old, while C. trachomatis and N. gonorrhoeae were the predominant pathogens isolated from the urethra of men less than 35 yr old. The etiologic role of E. coli and C. trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine or urethral cultures for these agents. C. trachomatis epididymitis accounted for 2/3 of idiopathic epididymitis in young men and often was associated with oligospermia. Of 9 female sexual partners of men with C. trachomatis infection 6 had antibody to C. trachomatis, of whom 2 had positive cervical cultures for this organism and 2 others had non-gonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with C. trachomatis epididymitis and should be offered to the female sex partners.