Epididymo-orchitis complicating Streptococcus pyogenes throat infection

Sebastiaan J van Hal and Robyn P Hardiman
Med J Aust 2003; 178 (2): 89. || doi: 10.5694/j.1326-5377.2003.tb05072.x
Published online: 20 January 2003

Epididymo-orchitis can result from bacterial or viral infections. Predisposing trauma may be identified, but the majority of cases appear to be idiopathic.

Different types of causative bacteria occur more frequently in certain age groups: 1,2 for example, urinary tract pathogens (eg, Escherichia coli, Proteus mirabilis, Enterobacter spp.) in men over 35 years; sexually acquired pathogens (eg, N. gonorrhoeae, C. trachomatis) in sexually active men under 35 years; and pathogens acquired as part of a systemic infection (eg, Haemophilus influenzae, N. meningitidis, Mycobacterium tuberculosis) in preadolescent boys.

In a few rare cases,1-3 streptococcal infections have been found to cause epididymo-orchitis as part of a local infection. However, all these cases occurred in preadolescent boys. There has been one report of a 17-year-old man with invasive group A streptococcal infection of the scrotum in the context of streptococcal toxic shock syndrome.4 Our case is unusual in that it occurred as a systemic illness in a 55-year-old man with haemochromatosis. This infection has not, to our knowledge, been previously described in association with haemochromatosis.5

  • Sebastiaan J van Hal1
  • Robyn P Hardiman2

  • Department of Infectious Diseases, Prince of Wales Hospital, Randwick, NSW.


  • 1. Ireton RC, Berger RE. Prostatitis and epididymitis. Urol Clin North Am 1984; 11: 83-94.
  • 2. Kaver I, Matzkin H, Braf ZF. Epididymo-orchitis: A retrospective study of 121 patients. J Fam Pract 1990; 30: 548-552.
  • 3. Teel LD, Shemonsky NK, Aronson N. Group G streptococcal bacteremia in a healthy young man. South Med J 1989; 82: 633-634.
  • 4. Walker BR, Pribble CG, Cartwright PC. Invasive group A Streptococcus infection of the scrotum and streptococcal toxic shock syndrome. J Urol 2000; 56: 669-670.
  • 5. Jurado RL. Iron, infections and anemia of inflammation. Clin Infect Dis 1997; 25: 888-895.


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