Treatment for Hand-Foot-Mouth Disease with Epididymitis

Epididymitis Treatment

The Centers for Disease Control and Prevention recommends ceftriaxone 250 mg IM in a single dose plus doxycycline 100 mg orally twice a day for 10 days for sexually transmitted epididymitis in men under 35 years 1
The Centers for Disease Control and Prevention suggests ofloxacin 300 mg orally twice a day for 10 days or levofloxacin 500 mg orally once daily for 10 days for epididymitis likely caused by enteric organisms in men over 35 years 1
Bed rest, scrotal elevation, and analgesics are recommended until fever and local inflammation subside, with reevaluation of diagnosis and therapy if no improvement within 3 days 1
Hospitalization should be considered if severe pain suggests other diagnoses or if the patient is febrile 2

A Gram-stained smear of urethral exudate is recommended for diagnosis of urethritis, along with culture or nucleic acid amplification test for N. gonorrhoeae and C. trachomatis 1
Examination of first-void urine for leukocytes is suggested if urethral Gram stain is negative 1
Syphilis serology and HIV counseling and testing are recommended 1

Patients with uncomplicated epididymitis who are HIV-positive should receive the same treatment regimen as HIV-negative patients, with awareness that fungi and mycobacteria are more likely to cause epididymitis in immunosuppressed patients 1
Patients with sexually transmitted epididymitis should refer sex partners for evaluation and treatment if contact occurred within 60 days preceding symptom onset, and avoid sexual intercourse until therapy is completed and symptoms have resolved 1
Swelling and tenderness that persist after completing antibiotics should be comprehensively evaluated for other conditions 1