Why is my left scrotum still swollen despite antibiotics?

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Based on your symptoms and what can be seen in the image, the left side of your scrotum appears swollen and inflamed. Taken together, these findings point toward a condition called epididymo-orchitis, which means an infection or inflammation of the testicle and the nearby tube (epididymis) that stores sperm. This type of infection often develops gradually and can take time to settle.

It is encouraging that you have noticed some improvement after starting Augmentin, as this shows the antibiotic is having an effect. However, since the swelling has not reduced significantly and you continue to have a mild fever at night along with headaches, it suggests that the infection may still be active and needs closer evaluation.

To better understand what is causing the infection and why it is persisting, a few simple tests are recommended while you await your ultrasound report:

1. Urine routine and culture, this helps detect infection in the urine and identifies the exact germ, allowing the antibiotic to be adjusted if needed.

2. Blood sugar tests (fasting and after meals) are necessary because high blood sugar can weaken the body’s ability to fight infection. Checking for diabetes is important, especially when infections take longer to heal.

3. Ultrasound KUB (kidneys, ureters, bladder), this scan looks for prostate enlargement, urine blockage, or stones, all of which can contribute to repeated or persistent testicular infections.

4. A scrotal Doppler ultrasound checks blood flow to the testicle and helps detect infection, swelling, or any pus collection.

Since the infection appears ongoing, treatment needs to be continued and supported properly:

1. Complete a full seven to ten-day course of Augmentin (Amoxicillin 500 mg and Clavulanic acid 125 mg), unless test results show that a different antibiotic would work better. If there is no clear improvement after seven days, the medicine may need to be changed based on the culture report.

2. Along with medication, scrotal support and cold compresses play an important role. Applying an ice pack for 10 to 15 minutes, three times a day, can help reduce pain and swelling.

3. Paracetamol may be taken for fever and headache as needed.

4. To prevent further strain, it is best to avoid prolonged standing, heavy physical activity, and sexual intercourse until the swelling subsides.

Despite treatment, if you notice worsening symptoms, such as:

1. Rising or persistent fever.

2. Increasing pain or swelling.

3. Redness spreading over the scrotum.

4. Any pus or fluid discharge.

You should consult your local doctor immediately, as these signs may indicate a worsening infection or pus formation, which may require drainage.

Your symptoms are most consistent with infective epididymo-orchitis, possibly linked to an underlying urinary infection or blockage, and sometimes influenced by conditions such as diabetes or prostate enlargement.

Please share your scrotal and KUB ultrasound reports once available, as they will help decide whether continuing the same antibiotic is sufficient or if further treatment is required.

I hope this helps.

Please revert in case of further queries.

Thank you.