Orchitis

Orchitis causes a painful, enlarged testis, but the same presentation can signal threatened testicular perfusion. In adults, bacterial epididymo-orchitis is a common infectious pattern: organisms ascend from the urethra or bladder, and the sexual and urinary history helps determine empiric coverage. The first decision is therefore urgent exclusion of torsion, followed by targeted testing, prompt treatment, and reassessment of the clinical response within 48–72 hours.