NR 576 Week 7 Assignment; Clinical Practice Guidelines; Understanding Acute Epididymitis and Its Management (Presentation Outline)

suspected case of acute epididymitis should be evaluated for objective evidence using the POC tests. Gram, MB, or GV stain of urethral secretions demonstrating ≥2 WBCs per oil immersion field These stains are preferred POC diagnostic tests for evaluating urethritis because they are highly sensitive and specific for documenting both urethral inflammation and presence or absence of gonococcal infection. Positive leukocyte esterase test on first-void urine. Microscopic examination of sediment from a spun first void urine demonstrating ≥10 WBCs/HPF. Also, all cases of acute epididymitis should be tested for C. trachomatis and N. gonorrhoeae by NAAT or known as the Nucleic Acid Amplification Test. As mentioned by the U.S. Department of Health and Human Services Centers for Disease Control and Prevention (2021) Slide 10: guideline statement: treatment. For acute epididymitis most likely caused by chlamydia or gonorrhea: Ceftriaxone 500 mg IM in a single dose plus Doxycycline 100 mg orally 2 times/day for 10 days. For acute epididymitis most likely caused by chlamydia, gonorrhea, or enteric organisms (men who practice insertive anal sex): Ceftriaxone 500 mg IM in a single dose plus Levofloxacin 500 mg orally once daily for 10 days. For acute epididymitis most likely caused by enteric organisms only: Levofloxacin 500 mg orally once daily for 10 days. As stated by the U.S. Department of Health and Human Services Centers for Disease Control and Prevention (2021). Slide 11: guideline statement: other considerations and follow up. Individuals who have acute epididymitis that is confirmed or suspected that is caused by N. gonorrhoeae or C. trachomatis should not have sex until they have been treated, or symptoms have resolved. Anyone with acute epididymitis should also be tested for HIV/syphilis. Follow up: if symptoms have not improved within 72-hours patients should be advised to return to their PCP. If men still have swelling/tenderness after therapy, they should be evaluated for different diagnosis: abscess, tumor, TB, or cancer. As stated by the U.S. Department of Health and Human Services Centers for Disease Control and Prevention (2021). Slide 12: guideline statement: special considerations. Drug allergy, intolerance, and adverse rd effects: The risk for penicillin cross reactivity is negligible between all 3 generation cephalosporins. Other regimens have not been observed nor studied so physicians need to consult infectious disease if they are needed. Having an HIV infection. Individuals who are HIV positive that have uncomplicated acute epididymitis should still receive the same Tx as those who are negative. Other etiological agents that go along men with HIV include, CMV, salmonella, Mycoplasma species, and Toxoplasmosis. According to the U.S. Department of Health and Human Services Centers for Disease Control and Prevention (2021). Slide 13: application in clinical. Slide 14: application in clinical. A 26-year-old male presents to the clinic with complaints of scrotal pain, swelling, and dysuria for the past 2 days. Patient does admit he is homosexual and has intercourse recently. Physical exam: scrotum is swollen, there is some tenderness to palpation, more on his left testicle, there was also tenderness to the posterior