Patient's typically present with acute scrotal pain and swelling, often accompanied by systemic features such as fever and rigors in severe cases.
The epididymis is tender and swollen, and the overlying scrotal skin, red and warm. Initially, the epididymis is palpable separately from the testis but becomes more difficult as the infection becomes established and inflammation spreads to the testis. A secondary hydrocoele may be noted.
Tenderness may be relieved by elevating the scrotum - Prehn's sign.
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