The testis may be acutely inflamed in a number of viral illnesses, for example, mumps, infectious mononucleosis, rubella and Coxsackie virus infection.
Mumps orchitis is the most common; 15-20% of adult males who contract mumps get orchitis. It is rare in boys before puberty.
Typically, testicular involvement occurs 3-7 days after parotid enlargement. Rarely, orchitis is the only feature of mumps. In 15% of cases, both testes are affected. Initially, the testis is swollen and the epididymis normal. Later, the entire scrotum becomes inflamed and oedematous. The urine is usually sterile. Diagnosis is confirmed by rising titres of anti-mumps antibodies.
Treatment is by bed rest, scrotal support and analgesia. Testicular atrophy occurs in 50% of cases and if bilateral, may cause sterility.
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