0521779407-16 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:18
1092 Orchitis and Epididymitis Osteoarthritis■Levofloxacin
➣Side effects: gastrointestinal upset, diarrhea, rare skin rash and
mental status changes in the elderly
➣Contraindications:
absolute: If patient has sexual contact with persons from
Southeast Asia or sexual contact in Hawaii, California, or New
England or is a male who has sex with males (resistant gono-
cocci)follow-up
■During treatment, patient should be examined at 3 days and re-
evaluated if failure to improve.
■If symptoms worsen, consider ultrasonography.
■If abscess formation or pyocele of the scrotum develops, do surgery.
■Persistent swelling after antimicrobial therapy could be evidence of
chronic epididymitis due to Mycobacteria or fungal infections.
■Patients with epididymitis due to sexually transmitted organisms
should refer all sex partners within the last 60 days for examination
and treatment and avoid sexual intercourse until therapy is com-
pleted.
■If patient has viral orchitis, semen analysis is indicated.
complications and prognosis
■Most patients recover. Sterility is a rare feature of epididymitis; it
does occur in viral orchitis.
■Rarely, abscess formation, pyocele, testicular infarction, chronic epi-
didymitis occur.OSTEOARTHRITIS
CHRIS WISE, MD
history & physical
History
■Pain in affected joint
■Symptoms worse w/ activity or weight bearing
■Most common in knees, hips, lumbar or cervical spine, specific
hand joints (carpal-metacarpal of thumb, proximal & distal inter-
phalangeals)
■Morning stiffness usually <1 h