{"id":1666,"date":"2020-09-25T08:00:00","date_gmt":"2020-09-25T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=1666"},"modified":"2026-08-29T05:21:49","modified_gmt":"2026-08-28T22:21:49","slug":"%ea%b3%a0%ed%99%98-%ea%b0%90%ec%97%bc-%ec%98%a4%ec%a0%84","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ko\/2020\/09\/25\/testicular-infection\/","title":{"rendered":"Am I Suffering from a Testicular Infection?"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=12%2C12&amp;ssl=1 12w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=600%2C600&amp;ssl=1 600w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=400%2C400&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=200%2C200&amp;ssl=1 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:75%\">\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/drsoaraweeurology.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Soarawee Weerasopone, Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-background-background-color has-text-color has-background has-link-color has-small-font-size has-custom-font-size wp-element-button\" href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" style=\"color:#1b4965\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<ul class=\"wp-block-social-links aligncenter has-normal-icon-size is-style-default coblocks-animate is-content-justification-center is-layout-flex wp-container-core-social-links-is-layout-3e41869c wp-block-social-links-is-layout-flex\"><li class=\"wp-social-link wp-social-link-wordpress wp-block-social-link\"><a href=\"https:\/\/drsoaraweeurology.com\/\" class=\"wp-block-social-link-anchor\"><svg width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M12.158,12.786L9.46,20.625c0.806,0.237,1.657,0.366,2.54,0.366c1.047,0,2.051-0.181,2.986-0.51 c-0.024-0.038-0.046-0.079-0.065-0.124L12.158,12.786z M3.009,12c0,3.559,2.068,6.634,5.067,8.092L3.788,8.341 C3.289,9.459,3.009,10.696,3.009,12z M18.069,11.546c0-1.112-0.399-1.881-0.741-2.48c-0.456-0.741-0.883-1.368-0.883-2.109 c0-0.826,0.627-1.596,1.51-1.596c0.04,0,0.078,0.005,0.116,0.007C16.472,3.904,14.34,3.009,12,3.009 c-3.141,0-5.904,1.612-7.512,4.052c0.211,0.007,0.41,0.011,0.579,0.011c0.94,0,2.396-0.114,2.396-0.114 C7.947,6.93,8.004,7.642,7.52,7.699c0,0-0.487,0.057-1.029,0.085l3.274,9.739l1.968-5.901l-1.401-3.838 C9.848,7.756,9.389,7.699,9.389,7.699C8.904,7.67,8.961,6.93,9.446,6.958c0,0,1.484,0.114,2.368,0.114 c0.94,0,2.397-0.114,2.397-0.114c0.485-0.028,0.542,0.684,0.057,0.741c0,0-0.488,0.057-1.029,0.085l3.249,9.665l0.897-2.996 C17.841,13.284,18.069,12.316,18.069,11.546z M19.889,7.686c0.039,0.286,0.06,0.593,0.06,0.924c0,0.912-0.171,1.938-0.684,3.22 l-2.746,7.94c2.673-1.558,4.47-4.454,4.47-7.771C20.991,10.436,20.591,8.967,19.889,7.686z M12,22C6.486,22,2,17.514,2,12 C2,6.486,6.486,2,12,2c5.514,0,10,4.486,10,10C22,17.514,17.514,22,12,22z\"><\/path><\/svg><span class=\"wp-block-social-link-label screen-reader-text\">\uc6cc\ub4dc\ud504\ub808\uc2a4<\/span><\/a><\/li>\n\n<li class=\"wp-social-link wp-social-link-linkedin wp-block-social-link\"><a href=\"https:\/\/www.linkedin.com\/in\/soarawee-weerasopone\/\" class=\"wp-block-social-link-anchor\"><svg width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M19.7,3H4.3C3.582,3,3,3.582,3,4.3v15.4C3,20.418,3.582,21,4.3,21h15.4c0.718,0,1.3-0.582,1.3-1.3V4.3 C21,3.582,20.418,3,19.7,3z M8.339,18.338H5.667v-8.59h2.672V18.338z M7.004,8.574c-0.857,0-1.549-0.694-1.549-1.548 c0-0.855,0.691-1.548,1.549-1.548c0.854,0,1.547,0.694,1.547,1.548C8.551,7.881,7.858,8.574,7.004,8.574z M18.339,18.338h-2.669 v-4.177c0-0.996-0.017-2.278-1.387-2.278c-1.389,0-1.601,1.086-1.601,2.206v4.249h-2.667v-8.59h2.559v1.174h0.037 c0.356-0.675,1.227-1.387,2.526-1.387c2.703,0,3.203,1.779,3.203,4.092V18.338z\"><\/path><\/svg><span class=\"wp-block-social-link-label screen-reader-text\">LinkedIn<\/span><\/a><\/li>\n\n<li class=\"wp-social-link wp-social-link-mail wp-block-social-link\"><a href=\"mailto:bhquro@bdms.co.th\" class=\"wp-block-social-link-anchor\"><svg width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M19,5H5c-1.1,0-2,.9-2,2v10c0,1.1.9,2,2,2h14c1.1,0,2-.9,2-2V7c0-1.1-.9-2-2-2zm.5,12c0,.3-.2.5-.5.5H5c-.3,0-.5-.2-.5-.5V9.8l7.5,5.6,7.5-5.6V17zm0-9.1L12,13.6,4.5,7.9V7c0-.3.2-.5.5-.5h14c.3,0,.5.2.5.5v.9z\"><\/path><\/svg><span class=\"wp-block-social-link-label screen-reader-text\">\uba54\uc77c<\/span><\/a><\/li><\/ul>\n\n\n\n<style>\n\/* Hover effect for Social Dr Pom Block - Social Icons *\/\n.wp-block-social-links .wp-social-link {\n  transition: transform 0.2s ease, opacity 0.2s ease !important;\n}\n.wp-block-social-links .wp-social-link:hover {\n  transform: scale(1.15);\n  opacity: 0.9;\n}\n<\/style>\n\n<div class=\"dr-pom-academic-icons\" style=\"display: flex; gap: 16px; margin-top: 12px; align-items: center; justify-content: center;\">\n  \n  <a href=\"https:\/\/www.researchgate.net\/profile\/Soarawee-Weerasopone\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ResearchGate Profile\"\n     aria-label=\"View ResearchGate Profile\"\n     style=\"text-decoration: none; color: #00CCBB; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M19.586 0c-.818 0-1.508.19-2.073.565-.563.377-.97.936-1.213 1.68a3.193 3.193 0 0 0-.112.437 8.365 8.365 0 0 0-.078.53 9 9 0 0 0-.05.727c-.01.282-.013.621-.013 1.016a31.121 31.121 0 0 0 .014 1.017 9 9 0 0 0 .05.727 7.946 7.946 0 0 0 .077.53h.001c.024.115.06.262.112.438.243.743.65 1.303 1.213 1.68.565.376 1.255.564 2.073.564.8 0 1.536-.213 2.105-.603.57-.39.94-.916 1.175-1.65.076-.235.135-.558.177-.93a15.4 15.4 0 0 0 .063-1.207v-.512a.27.27 0 0 0-.273-.273h-2.95a.27.27 0 0 0-.274.273v.785c0 .228.0.343.273.343h1.337c.094 0 .14.045.14.137 0 .61-.063 1.043-.155 1.318-.182.546-.7 1.018-1.683 1.018-.654 0-1.135-.114-1.475-.356-.34-.244-.55-.585-.658-1.024a3.797 3.797 0 0 1-.111-.43 5.515 5.515 0 0 1-.06-.51 19.85 19.85 0 0 1-.025-.726c-.004-.28-.004-.628-.004-1.045 0-.418 0-.766.004-1.046a19.85 19.85 0 0 1 .025-.726 5.475 5.475 0 0 1 .06-.51 3.785 3.785 0 0 1 .111-.43c.108-.44.318-.78.658-1.024.34-.243.82-.357 1.475-.357.6 0 1.064.078 1.413.293.347.215.595.515.74.91.063.155.166.21.31.156l.967-.4c.15-.058.187-.18.13-.32a3.025 3.025 0 0 0-1.262-1.452C21.12.218 20.428.0 19.586 0zM8.512 4.32c-2.7 0-4.066.997-4.066 3.06v.04c0 1.92.992 2.83 3.046 2.83 1.27 0 2.038-.39 2.385-1.05h.13l.067.51c.04.2.207.34.41.34h.99V7.95c0-2.59-1.06-3.63-2.962-3.63zm-.18 1.61c1.118 0 1.628.56 1.628 1.86v.4l-1.65.16c-1.35.13-1.86.46-1.86 1.13v.04c0 .67.41 1.06 1.45 1.06.85 0 1.55-.32 1.93-.84.04-.06.13-.07.18-.02.05.03.07.1.07.16v.43c0 .26.13.42.34.42h1.05c.21 0 .34-.16.34-.42v-3.6c0-1.94-1.13-2.83-3.46-2.83-1.94 0-3.07.86-3.4 2.04l1.55.45c.18-.69.6-1.04 1.83-1.04zM2.135 16.314c-.587 0-1.066-.156-1.434-.469-.367-.312-.618-.704-.752-1.176-.034-.124-.061-.232-.082-.327a3.794 3.794 0 0 1-.044-.366 8.83 8.83 0 0 1-.022-.547C0 13.221 0 12.985 0 12.704c0-.281 0-.515.001-.704a8.81 8.81 0 0 1 .022-.547 3.802 3.802 0 0 1 .044-.366c.02-.094.048-.203.082-.328.134-.471.385-.864.752-1.176.368-.313.847-.469 1.434-.469.477 0 .892.087 1.246.262.353.175.622.443.806.804.044.083.083.157.117.222.034.066.069.144.105.235.022.054.011.099-.034.135l-.66.292c-.045.027-.082.013-.112-.045a4.043 4.043 0 0 0-.155-.27 1.247 1.247 0 0 0-.49-.495c-.225-.131-.522-.196-.892-.196-.402 0-.726.064-.972.193-.247.13-.422.302-.527.518-.027.045-.054.099-.082.16a1.39 1.39 0 0 0-.067.197 2.46 2.46 0 0 0-.05.282 5.51 5.51 0 0 0-.033.43c-.008.17-.013.376-.013.617 0 .242.005.448.013.618.008.17.02.314.034.43.013.117.03.21.05.282.02.072.042.137.066.197.105.216.28.39.527.518.246.13.57.193.972.193.4 0 .714-.07.94-.21.227-.14.394-.346.503-.617a2.43 2.43 0 0 0 .104-.395c.018-.123.027-.282.027-.477V13.2H2.34c-.04 0-.06-.02-.06-.062v-.5c0-.04.02-.062.06-.062h1.812c.04 0 .062.02.062.06v.5c0 .156-.005.296-.014.422a4.71 4.71 0 0 1-.04.342 1.732 1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">A painful, swollen testicle is one of the commoner reasons men come to see me. It is usually an infection, and it usually affects one side only \u2014 both testicles being infected at the same time is unusual. In practice the testicle is rarely the only organ involved: the infection almost always involves the epididymis alongside it.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Before Anything Else: The Diagnosis That Must Be Excluded First<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Sudden severe testicular pain can also be <strong>testicular torsion<\/strong>, where the testicle twists on its own blood supply. That is a surgical emergency, and the tissue begins to die within hours. <strong>If the pain came on suddenly and severely, go to an emergency department now rather than waiting to see whether it settles.<\/strong> In Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The clinical patterns help. Torsion is more typical in younger males, usually arrives abruptly at full intensity \u2014 often waking someone from sleep \u2014 commonly brings nausea or vomiting, and usually comes without fever or urinary symptoms. An infection builds more gradually and often comes with fever or burning on passing urine. But those patterns are tendencies, not rules, and they are not reliable enough to bet a testicle on.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>An important correction to the earlier version of this page.<\/strong> It said that where there is doubt, an urgent scrotal ultrasound settles the question. That is not right, and it is the single most consequential error this article contained. <strong>A normal Doppler ultrasound does not exclude torsion<\/strong> \u2014 blood flow can still be detected in a testicle that is twisted, particularly where the rotation is partial or the scan is done early, and the quality of the study depends heavily on who performs it. Torsion is a clinical diagnosis. Where the history and examination point to it, the correct step is surgical exploration, not reassurance from a scan. If you are told your scan was normal but the pain began suddenly, is severe and is not settling, say so and ask to be seen by a urologist before you are sent home. The full account, including how salvage rates fall with each hour, is in <a href=\"https:\/\/drsoaraweeurology.com\/2021\/02\/19\/testicular-torsion-urologic-emer\/\">testicular torsion: sudden severe pain in one testicle is an emergency<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One related pattern is worth mentioning to your doctor even when nothing hurts today: <strong>repeated brief attacks of severe testicular pain that resolve on their own<\/strong> within minutes to an hour. That is <a href=\"https:\/\/drsoaraweeurology.com\/2022\/04\/01\/intermittent-testicular-torsion\/\">intermittent torsion<\/a>, and because the episodes settle they are usually dismissed \u2014 yet they identify anatomy that can be fixed as a planned operation before the episode that does not resolve.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The epididymis is a coiled tubular structure attached to the back and upper part of each testicle, where sperm mature before ejaculation. Because the two structures sit so close together, infection commonly affects both \u2014 which is why the medical term is <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK553165\/\">epididymo-orchitis<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1672\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/2020\/09\/11\/premature-ejaculation-self-fix\/3-d-illustration-of-bacteria-in-microflora-blue-bacterium-on-a-red-surface\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;Alena Kilchytskaya&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;3 d illustration of bacteria in microflora. Blue bacterium on a red surface.  Close up.&quot;,&quot;created_timestamp&quot;:&quot;1560101525&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;3 d illustration of bacteria in microflora. Blue bacterium on a red surface.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"E coli is the most common bacterial-related cause.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;E coli is the most common bacterial-related cause.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?resize=800%2C533&#038;ssl=1\" alt=\"E. coli bacteria, the commonest bacterial cause of testicular infection\" class=\"wp-image-1672\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/E-coli.jpg?resize=768%2C512&amp;ssl=1 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">E. coli is the commonest bacterial cause.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Where the infection comes from<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The mechanism resembles a bladder infection: bacteria travel backwards from the urethra into the genital tract. In older men this is usually E. coli, and it raises the question of whether anything is obstructing the flow of urine. In younger, sexually active men the leading causes are sexually transmitted infections \u2014 chlamydia and gonorrhoea \u2014 which is why a <a href=\"https:\/\/drsoaraweeurology.com\/2020\/05\/28\/stis-std-pcr-urine-test\/\">urine PCR panel<\/a> is often the more useful test in that group. Heavy or repetitive physical exertion is sometimes blamed; strain can certainly aggravate the pain, but it is not an established cause on its own and should not be allowed to explain away a swollen testicle.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">The viral cause that is often forgotten: mumps<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Not every testicular infection is bacterial. <strong>Mumps can inflame the testicle<\/strong>, and it is commoner than most people expect in an unvaccinated or incompletely vaccinated male past puberty. Historical figures from before routine vaccination put orchitis in a wide range around <strong>15% to 30%<\/strong> of post-pubertal males with mumps; in outbreaks in vaccinated populations the figure has been far lower, in the region of 3% to 10%. It is rare before puberty.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It typically begins <strong>four to eight days after the parotid glands swell<\/strong>, although intervals of up to several weeks have been reported \u2014 and it can occur without any obvious swelling of the face at all, which is how the diagnosis gets missed. It affects one side in the large majority of cases, <strong>roughly 60% to 80%<\/strong>, and both sides in the remainder.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This matters for two reasons. <strong>Antibiotics do nothing for it<\/strong>, so a man treated as though he had a bacterial infection does not improve and is often given a second and third course. And unlike bacterial infection, it can leave lasting effects: some reduction in the size of the affected testicle occurs in up to about half of cases, and abnormalities on a semen analysis in up to about a quarter.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The reassurance that belongs beside those numbers, because it is the part men actually want:<\/strong> a smaller testicle and an abnormal semen result are not the same as being unable to father a child. <strong>Sterility is rare, even when both testicles were affected.<\/strong> If it worries you, a semen analysis some months after recovery answers the question for you specifically rather than in the abstract. Treatment is supportive: rest, scrotal support, anti-inflammatory medication and time. Vaccination is what prevents it.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"480\" data-attachment-id=\"1673\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/2020\/09\/11\/premature-ejaculation-self-fix\/bacteria-in-colon\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?fit=1200%2C720&amp;ssl=1\" data-orig-size=\"1200,720\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1527008785&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"E coli live peacefully in our GI tract but not Urinary tract system\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;E coli live peacefully in our GI tract but not Urinary tract system&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?fit=800%2C480&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?resize=800%2C480&#038;ssl=1\" alt=\"Gut bacteria, which live harmlessly in the intestine but cause infection in the urinary tract\" class=\"wp-image-1673\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?resize=300%2C180&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?resize=1024%2C614&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/Bacteria-in-colon.jpg?resize=768%2C461&amp;ssl=1 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">E. coli lives harmlessly in the gastrointestinal tract \u2014 but not in the urinary tract.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">How testicular infection is treated<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Treatment follows the organism most likely to be responsible, and the two groups are treated quite differently. Getting that split right at the first visit matters more than anything else in the management.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Where a sexually transmitted organism is likely<\/strong> \u2014 a younger, sexually active man \u2014 the current standard is <strong>an injection of ceftriaxone together with a course of oral doxycycline<\/strong>, which covers gonorrhoea and chlamydia respectively. A single antibiotic does not cover both. <strong>Current sexual partners need testing and treatment too<\/strong>, otherwise reinfection follows; what that involves in practice is set out in the article on <a href=\"https:\/\/drsoaraweeurology.com\/2021\/10\/15\/gonorrhea-infection-guideline\/\">gonorrhoea treatment<\/a>.<\/li>\n\n\n<li><strong>Where an enteric organism such as E. coli is likely<\/strong> \u2014 an older man, a man with an obstructing prostate, or after urological instrumentation \u2014 a fluoroquinolone such as levofloxacin or ofloxacin is used, adjusted once the urine culture identifies the organism.<\/li>\n\n\n<li><strong>Where both are plausible<\/strong>, which is not unusual, the regimens are combined rather than chosen between.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Doses and durations are set by the treating doctor and are not given here. Mumps orchitis, being viral, is not treated with any of this.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A word about fluoroquinolones.<\/strong> Where they are the right choice, they are an effective one, but they are not a harmless class. Regulators in the United States and Europe carry warnings about tendon inflammation and rupture, aortic aneurysm and dissection, peripheral nerve damage, effects on the central nervous system, disturbances of blood sugar and prolongation of the heart\u2019s QT interval, and they can provoke a difficult bowel infection. Practical consequences: <strong>new pain in a tendon \u2014 most often the heel \u2014 means stopping the drug and being reviewed the same day<\/strong>, and so does sudden severe pain in the abdomen, chest or back, or new numbness, tingling or burning in the hands or feet, since nerve damage from this class can be permanent. Finish a course that is genuinely indicated; do not accept repeat courses for a testicle that was never proven to be infected.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pain is managed well with anti-inflammatory medication, scrotal support and ice packs. One point is worth telling every patient in advance: when treatment is working, <strong>the pain settles first, but the scrotal swelling can take weeks to months to resolve completely<\/strong>. That lag is normal and does not mean the treatment has failed.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Come back sooner rather than later<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Return for review, or attend an emergency department, if <strong>the pain worsens despite antibiotics<\/strong>, if <strong>a high fever or shaking chills develop or you feel systemically unwell<\/strong>, or if <strong>the scrotum becomes red, tense or increasingly swollen<\/strong>. These can signal an abscess or a more serious infection that antibiotics alone will not settle. Rapidly spreading redness of the scrotum with severe pain and feeling very unwell needs the emergency department immediately rather than a clinic appointment. In Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There is one further reason not to let this drift. <strong>A lump that is still there after the infection has settled is not part of the infection and needs assessing.<\/strong> Testicular tumours are usually painless, but not always, and an episode of pain is a common moment for a man to notice a lump he then attributes entirely to the infection. If anything firm remains once everything else has resolved, have it examined. Persistent testicular discomfort with everything normal on testing is a different problem again \u2014 that is <a href=\"https:\/\/drsoaraweeurology.com\/2020\/11\/13\/scrotal-pain-syndrome-annoy\/\">scrotal pain syndrome<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1674\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ko\/2020\/09\/11\/premature-ejaculation-self-fix\/a-doctor-offers-a-condom-for-safe-sex-protection-against-sexually-transmitted-diseases\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.2&quot;,&quot;credit&quot;:&quot;Roman Budnyi&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark II&quot;,&quot;caption&quot;:&quot;A doctor offers a condom for safe sex. protection against sexually transmitted diseases.&quot;,&quot;created_timestamp&quot;:&quot;1582214062&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;A doctor offers a condom for safe sex. protection against sexually transmitted diseases&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Always use condom when at risk of STDs-exposed\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Always use condom when at risk of STDs-exposed&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Condom use, the main way to prevent the sexually transmitted causes of testicular infection\" class=\"wp-image-1674\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/09\/STD-prevent.jpg?resize=768%2C512&amp;ssl=1 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Consistent condom use prevents the sexually transmitted causes.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Once the patient is improving, the underlying cause still needs identifying \u2014 that is what prevents the next episode. That means safe sex practices and partner treatment where an STI was responsible, and in older men an assessment of whether the bladder is emptying properly or anything is obstructing it. Testing and vaccination services are described on the <a href=\"https:\/\/drsoaraweeurology.com\/services\/sti-testing-treatment-bangkok\/\">STI testing and treatment<\/a> page.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you are dealing with this, see a urologist rather than waiting it out \u2014 and if the pain began suddenly and severely, treat it as an emergency.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have painful or swollen testicles and would like proper diagnosis and treatment, Dr. Soarawee Weerasopone offers specialist consultations at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok Hospital Headquarters<\/a>. Appointments at Samitivej Sriracha Hospital in Chonburi can be arranged by calling the Urology department on <a href=\"tel:0880221445\">088-022-1445<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for non-urgent consultations, including for international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital rather than through this website. <strong>An acutely painful testicle is not a telemedicine problem \u2014 it needs examining in person, today.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions about Testicular Infection (Epididymo-Orchitis)<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1\"><strong class=\"schema-faq-question\">What is epididymo-orchitis?<\/strong> <p class=\"schema-faq-answer\">Epididymo-orchitis is an infection involving both the epididymis and the testicle. The epididymis is a coiled tube attached to the back of each testicle where sperm mature. Because the two structures lie closely together, infection often spreads to affect both simultaneously, resulting in pain, swelling, and tenderness of the affected side of the scrotum.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-2\"><strong class=\"schema-faq-question\">What causes testicular infection?<\/strong> <p class=\"schema-faq-answer\">Testicular infection most commonly results from bacteria spreading backwards from the urethra or urinary tract, with E. coli being the most frequent cause in older men. In younger sexually active men, sexually transmitted infections such as Chlamydia trachomatis and Neisseria gonorrhoeae are the leading causes. Mumps is an important viral cause in unvaccinated males past puberty, and antibiotics do nothing for it. In older men, obstruction to the flow of urine may be an underlying factor.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-3\"><strong class=\"schema-faq-question\">How is testicular infection treated?<\/strong> <p class=\"schema-faq-answer\">Treatment depends on the likely organism. Where a sexually transmitted infection is likely, the current standard is an injection of ceftriaxone together with a course of oral doxycycline, covering gonorrhoea and chlamydia respectively \u2014 a single antibiotic does not cover both \u2014 and current sexual partners need testing and treatment as well to prevent reinfection. Where an enteric organism such as E. coli is likely, a fluoroquinolone such as levofloxacin or ofloxacin is used, adjusted once urine culture identifies the organism. Where both are plausible the regimens are combined. Mumps orchitis is viral and is managed supportively. Supportive care includes anti-inflammatory medication, scrotal elevation and ice packs.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-4\"><strong class=\"schema-faq-question\">How long does it take for the swelling to go away after testicular infection?<\/strong> <p class=\"schema-faq-answer\">With appropriate treatment, pain typically improves within a few days. However, scrotal swelling can persist for several weeks to months even after the infection has been cleared. This is normal and does not necessarily indicate treatment failure. Worsening pain despite antibiotics, high fever or shaking chills, or a red, tense and increasingly swollen scrotum should prompt earlier review or an emergency department visit. A firm lump that remains once everything else has settled is not part of the infection and needs examining.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-5\"><strong class=\"schema-faq-question\">How do I know if it is testicular torsion and not infection?<\/strong> <p class=\"schema-faq-answer\">You often cannot tell reliably, which is why sudden severe testicular pain is treated as an emergency until proven otherwise. Torsion typically begins abruptly at full intensity in a younger male, often waking him from sleep and bringing nausea, usually without fever or urinary symptoms, while infection builds over days with fever or burning on passing urine. Importantly, a normal Doppler ultrasound does not exclude torsion: flow can persist when the rotation is partial, and accuracy depends on the operator. Torsion is a clinical diagnosis, and where the history and examination fit, surgical exploration is correct regardless of the scan. Go to an emergency department; in Thailand, call 1669.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-6\"><strong class=\"schema-faq-question\">Can a testicular infection affect my fertility?<\/strong> <p class=\"schema-faq-answer\">Bacterial epididymo-orchitis treated promptly usually does not cause lasting fertility problems, although scarring after a severe or repeatedly untreated infection can obstruct the passage of sperm on that side. Mumps orchitis carries more risk: some reduction in the size of the affected testicle occurs in up to about half of cases and abnormalities on a semen analysis in up to about a quarter. The important reassurance is that sterility is rare, even when both testicles were affected. If you are concerned, a semen analysis some months after recovery answers the question for you individually rather than in the abstract.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-7\"><strong class=\"schema-faq-question\">Can mumps cause testicular infection without the usual facial swelling?<\/strong> <p class=\"schema-faq-answer\">Yes, and that is how the diagnosis is most often missed. Mumps orchitis typically begins four to eight days after the parotid glands swell, but it can occur without any obvious swelling of the face, and intervals of up to several weeks have been reported. It affects one side in roughly 60% to 80% of cases. It is commonest in unvaccinated or incompletely vaccinated males past puberty and is rare before puberty. Antibiotics are ineffective; treatment is rest, scrotal support, anti-inflammatory medication and time, and vaccination is what prevents it.<\/p><\/div><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">References<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Justice ED, Fricker J, Ross JDC, et al. The 2024 European guideline on the management of epididymo-orchitis. <em>J Eur Acad Dermatol Venereol<\/em>. 2025.<\/li>\n\n\n<li>Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. <em>MMWR Recomm Rep<\/em>. 2021;70(4):1\u2013187.<\/li>\n\n\n<li>Hviid A, Rubin S, M\u00fchlemann K. Mumps. <em>Lancet<\/em>. 2008;371(9616):932\u2013944.<\/li>\n<\/ul>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/09\/25\/testicular-infection\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2020\/09\/25\/testicular-infection\/\",\n      \"name\": \"Am I Suffering from a Testicular Infection?\",\n      \"description\": \"Epididymo-orchitis explained: where the infection comes from, the mumps cause that antibiotics do not touch, how sexually transmitted and enteric causes are treated differently, why swelling outlasts the pain, and why sudden severe testicular pain must be treated as possible torsion regardless of the ultrasound.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2020-09-25\",\n      \"dateModified\": \"2026-08-29\",\n      \"lastReviewed\": \"2026-08-29\",\n      \"specialty\": \"https:\/\/schema.org\/Urologic\",\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/09\/25\/testicular-infection\/#epididymo-orchitis\" },\n      \"citation\": [\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"The 2024 European guideline on the management of epididymo-orchitis\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"Journal of the European Academy of Dermatology and Venereology\" }, \"datePublished\": \"2025\", \"identifier\": \"10.1111\/jdv.20865\" },\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"Sexually transmitted infections treatment guidelines, 2021\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"MMWR Recommendations and Reports\" }, \"datePublished\": \"2021\", \"identifier\": \"10.15585\/mmwr.rr7004a1\" },\n        { \"@type\": \"ScholarlyArticle\", \"name\": \"Mumps\", \"isPartOf\": { \"@type\": \"Periodical\", \"name\": \"The Lancet\" }, \"datePublished\": \"2008\", \"identifier\": \"10.1016\/S0140-6736(08)60419-5\" }\n      ],\n      \"significantLink\": [\n        \"https:\/\/drsoaraweeurology.com\/2021\/02\/19\/testicular-torsion-urologic-emer\/\",\n        \"https:\/\/drsoaraweeurology.com\/2022\/04\/01\/intermittent-testicular-torsion\/\",\n        \"https:\/\/drsoaraweeurology.com\/2020\/11\/13\/scrotal-pain-syndrome-annoy\/\",\n        \"https:\/\/drsoaraweeurology.com\/2021\/10\/15\/gonorrhea-infection-guideline\/\",\n        \"https:\/\/drsoaraweeurology.com\/2020\/05\/28\/stis-std-pcr-urine-test\/\"\n      ],\n      \"disambiguatingDescription\": \"CORRECTION NOTICE: an earlier version of this page stated that where torsion cannot be excluded clinically, an urgent scrotal ultrasound settles the question. That is wrong and has been corrected. A normal Doppler ultrasound does not exclude testicular torsion, because flow may persist with partial rotation and accuracy is operator-dependent. Torsion is a clinical diagnosis and surgical exploration should not be deferred by imaging. Revised 29 August 2026 with verified figures and regimens: for sexually transmitted causes the current standard is ceftriaxone by injection plus oral doxycycline, since a single agent does not cover both gonorrhoea and chlamydia; a fluoroquinolone is used where enteric organisms are likely, and the regimens are combined where both are plausible. Mumps orchitis figures added: approximately 15 to 30 percent of post-pubertal males in the pre-vaccine era and 3 to 10 percent in vaccine-era outbreaks, onset typically four to eight days after parotitis and sometimes without parotitis at all, unilateral in roughly 60 to 80 percent, testicular atrophy in up to about half and semen abnormalities in up to about a quarter, with sterility rare even after bilateral involvement. Hypoglycaemia and QT prolongation added to the fluoroquinolone class warnings. No doses are given on this page.\"\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/09\/25\/testicular-infection\/#epididymo-orchitis\",\n      \"name\": \"Epididymo-orchitis\",\n      \"alternateName\": \"Testicular infection\",\n      \"description\": \"Infection of the testicle together with the epididymis, the coiled tube behind it where sperm mature. It usually affects one side. Bacteria travel backwards from the urethra into the genital tract, typically E. coli in older men and sexually transmitted chlamydia or gonorrhoea in younger sexually active men; mumps is an important viral cause in unvaccinated males past puberty and does not respond to antibiotics. With treatment the pain settles within days, but scrotal swelling can take weeks to months to resolve, which is normal rather than treatment failure.\",\n      \"signOrSymptom\": [\n        {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Painful, swollen testicle, usually one side\"},\n        {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Fever\"},\n        {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Urinary symptoms such as burning on passing urine\"}\n      ],\n      \"riskFactor\": [\n        {\"@type\": \"MedicalRiskFactor\", \"name\": \"Sexually transmitted infection (chlamydia, gonorrhoea) in younger sexually active men\"},\n        {\"@type\": \"MedicalRiskFactor\", \"name\": \"Urinary tract infection with E. coli, more typical in older men\"},\n        {\"@type\": \"MedicalRiskFactor\", \"name\": \"Obstruction to urine flow, anatomical abnormality, or recent urological instrumentation\"},\n        {\"@type\": \"MedicalRiskFactor\", \"name\": \"Absent or incomplete mumps vaccination in a male past puberty\"}\n      ],\n      \"differentialDiagnosis\": [\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": { \"@type\": \"MedicalCondition\", \"name\": \"Testicular torsion\" },\n          \"distinguishingSign\": {\n            \"@type\": \"MedicalSignOrSymptom\",\n            \"name\": \"Sudden severe onset at full intensity, often waking the patient from sleep, commonly with nausea, typically without fever or urinary symptoms\",\n            \"description\": \"Testicular torsion is a surgical emergency in which the testicle twists on its own blood supply, and delay can mean permanently losing it. A normal Doppler ultrasound does NOT exclude torsion: flow may persist with partial rotation and accuracy is operator-dependent. Torsion is a clinical diagnosis, and where the history and examination fit, surgical exploration is correct regardless of the scan. Sudden severe testicular pain requires immediate emergency department assessment; the Thai emergency number is 1669.\"\n          }\n        },\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": { \"@type\": \"MedicalCondition\", \"name\": \"Mumps orchitis\" },\n          \"distinguishingSign\": {\n            \"@type\": \"MedicalSignOrSymptom\",\n            \"name\": \"Onset four to eight days after parotid swelling in an unvaccinated or incompletely vaccinated male past puberty, sometimes without any parotitis\",\n            \"description\": \"Viral and unresponsive to antibiotics, so failure to improve on antibiotic treatment should raise it. Unilateral in roughly 60 to 80 percent of cases. Some reduction in testicular size follows in up to about half of cases and semen abnormalities in up to about a quarter, but sterility is rare even after bilateral involvement.\"\n          }\n        },\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": { \"@type\": \"MedicalCondition\", \"name\": \"Testicular tumour\" },\n          \"distinguishingSign\": {\n            \"@type\": \"MedicalSignOrSymptom\",\n            \"name\": \"A firm lump that remains after the infection has otherwise resolved\",\n            \"description\": \"Testicular tumours are usually painless but not always, and an episode of pain is a common moment for a man to notice a lump he then attributes to the infection. Anything firm persisting after resolution requires examination rather than reassurance.\"\n          }\n        }\n      ],\n      \"typicalTest\": [\n        {\"@type\": \"MedicalTest\", \"name\": \"Urine culture\"},\n        {\"@type\": \"MedicalTest\", \"name\": \"Urine PCR panel for sexually transmitted organisms in younger sexually active men\"},\n        {\"@type\": \"MedicalTest\", \"name\": \"Scrotal ultrasound\", \"description\": \"Supportive but not decisive for torsion: a normal Doppler study does not exclude it and must not delay surgical exploration where clinical suspicion is high.\"},\n        {\"@type\": \"MedicalTest\", \"name\": \"Semen analysis some months after recovery where fertility is a concern, particularly after mumps orchitis\"}\n      ],\n      \"possibleTreatment\": [\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Ceftriaxone by injection plus oral doxycycline\", \"description\": \"Current standard where a sexually transmitted organism is likely, covering gonorrhoea and chlamydia respectively; a single agent does not cover both. Current sexual partners require testing and treatment, otherwise reinfection follows. Doses are set by the treating clinician.\"},\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Fluoroquinolone such as levofloxacin or ofloxacin\", \"description\": \"Used where an enteric organism such as E. coli is likely, adjusted once urine culture identifies the organism. Combined with ceftriaxone and doxycycline where both sexually transmitted and enteric causes are plausible.\", \"seriousAdverseOutcome\": {\"@type\": \"MedicalEntity\", \"name\": \"Fluoroquinolone class effects: tendon inflammation and rupture, aortic aneurysm and dissection, peripheral neuropathy which may be permanent, central nervous system effects, dysglycaemia, QT prolongation and Clostridioides difficile colitis. New tendon pain, most often in the heel, sudden severe abdominal, chest or back pain, or new numbness, tingling or burning in the hands or feet means stopping the drug and being reviewed the same day.\"}},\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Supportive care for mumps orchitis\", \"description\": \"Mumps orchitis is viral and does not respond to antibiotics. Management is rest, scrotal support, anti-inflammatory medication and time. Vaccination is what prevents it.\"},\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Supportive care\", \"description\": \"Anti-inflammatory medication, scrotal support and ice packs.\"}\n      ],\n      \"possibleComplication\": [\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Scrotal abscess or severe soft-tissue infection\",\n          \"description\": \"Suspected when pain worsens despite antibiotics, a high fever or shaking chills develop, or the scrotum becomes red, tense or increasingly swollen. Rapidly spreading scrotal redness with severe pain and systemic illness requires immediate emergency department assessment rather than a clinic appointment.\"\n        },\n        {\n          \"@type\": \"MedicalEntity\",\n          \"name\": \"Impaired fertility\",\n          \"description\": \"Uncommon after promptly treated bacterial infection, though scarring after severe or repeatedly untreated infection can obstruct sperm passage on that side. After mumps orchitis, some reduction in testicular size occurs in up to about half of cases and semen abnormalities in up to about a quarter, but sterility is rare even when both testicles were affected. A semen analysis some months after recovery answers the question for an individual.\"\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for general education only and does not constitute medical advice, diagnosis or treatment for any individual, and it gives no doses. <strong>Sudden severe testicular pain is a medical emergency \u2014 attend an emergency department immediately rather than waiting for an appointment, and do not be reassured by a normal ultrasound if the pain fits.<\/strong> No advice, diagnosis or prescription is given through personal messaging channels or social media, and Dr. Soarawee operates no public social media account. Always consult a qualified doctor about your own symptoms. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A painful, swollen testicle usually means epididymo-orchitis \u2014 but it can also mean torsion, which costs the testicle if it is missed. Dr. Soarawee Weerasopone, urologist at Bangkok Hospital, explains the causes, the treatment, and the one diagnosis that has to be ruled out first.<\/p>","protected":false},"author":185281453,"featured_media":10104,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Painful swollen testicle? Dr. Soarawee explains testicular infection (epididymo-orchitis) \u2014 its causes, treatment options, and how to tell it apart from the surgical emergency of testicular torsion.","jetpack_seo_html_title":"Testicular Infection (Epididymo-Orchitis): Causes & Treatment | Dr. Soarawee Urology","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1362],"tags":[1469,1470,1468,1454],"class_list":["post-1666","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-infection","tag-epididymoorchitis","tag-orchitis","tag-testicular-infection","tag-testicular-pain"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-qS","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Testicular-Infection.jpg?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/posts\/1666","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/comments?post=1666"}],"version-history":[{"count":26,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/posts\/1666\/revisions"}],"predecessor-version":[{"id":11783,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/posts\/1666\/revisions\/11783"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/media\/10104"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/media?parent=1666"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/categories?post=1666"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ko\/wp-json\/wp\/v2\/tags?post=1666"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}