Orchitis
Orchitis is inflammation of the testicle itself, often occurring together with epididymitis, per the 2024 European Guideline on the Management of Epididymo-Orchitis.
Symptoms
Testicular pain and swelling, sometimes with fever, and in mumps-related cases, swelling that follows a few days after parotid gland (jaw/cheek) swelling.
Causes and risk
Mumps remains a real cause even in vaccinated populations; Coxsackievirus is now recognized as a leading viral cause of isolated orchitis. Bacterial orchitis usually occurs alongside epididymitis from the same organisms (STI-related or urinary bacteria).
How it is evaluated
Exam and Doppler ultrasound help confirm the diagnosis and, critically, rule out testicular torsion, which can look similar early on.
Treatment
Bacterial cases are treated with antibiotics matched to the likely organism (STI-related versus urinary). Viral orchitis (mumps, Coxsackievirus) is managed with supportive care -- rest, scrotal support, and pain control -- since there's no specific antiviral treatment.
When to seek care
Because torsion can mimic orchitis early on and the window to save the testicle is short, any sudden or severe testicular pain should go to the emergency department for an ultrasound rather than being assumed to be orchitis.