Persistent Orchitis: Concerns for HIV Patients

Orchitis has not improved for a long time?

Hello, I would like to briefly mention that I have HIV and have not been on medication for several years (I won't elaborate on the reasons).
At the beginning of the month, I experienced swelling and pain in my right epididymis and testicle, which led me to visit the emergency room, and I was subsequently hospitalized.
Of course, for the safety of the medical staff, I informed them about my HIV status and explained that I had not been on medication (I won't repeat this explanation).
I was hospitalized for three days, during which I received intravenous antibiotics and pain relief.
I was eager to be discharged, but during a follow-up visit a few days ago, I was told I needed to be hospitalized again because I informed the doctor that my testicle had not decreased in size; it remained swollen, and I continued to experience chills and fever.
I hesitated and thought I would just take the medication for a few more days, so I went home.

Today, I carefully examined and palpated my right testicle, and it is still swollen.
The shape has started to change, with a protrusion in one area, while the rest feels hard, and this particular area seems to have some fluid.
I am unsure if this is a protrusion of the testicle or just on the surface, but it cannot be moved.
Therefore, I would like to ask if I should continue the course of antibiotics? I have read some articles that suggest it may take a while for the swelling to subside, so is this still considered normal (I am still experiencing chills and fever today, but it is not as severe as before)? Throughout this process, aside from the initial blood test (which showed low potassium) and IV fluids, there have been no other examinations (only consultations, which may not have been necessary; I am not sure).
Could it be that my weakened immune system is affecting this situation? I would appreciate your clarification.

Brown, 40~49 year old female. Ask Date: 2020/02/15

Dr. Du Mingyi reply Urology

Even individuals with normal immune function may take two weeks to recover from testicular inflammation.
For those with compromised immunity, if they are unwilling to follow the doctor's advice, there may be no one who can help them.

Reply Date: 2020/02/15

More Info

Hello, thank you for sharing your concerns regarding persistent orchitis and its implications for someone living with HIV. Given your situation, it’s important to address both the immediate health concerns and the broader context of living with HIV, especially when not on antiretroviral therapy (ART).

Firstly, persistent orchitis, which is inflammation of the testicles, can be caused by various factors, including infections (viral or bacterial), trauma, or even autoimmune responses. In your case, since you have a history of HIV and are currently not on medication, your immune system may be compromised, making you more susceptible to infections. This could potentially lead to complications such as persistent swelling and pain in the testicles.

The fact that you are experiencing ongoing symptoms such as fever and chills, along with the persistent swelling of the right testicle, is concerning. It indicates that there may be an underlying infection or another issue that requires further investigation. While antibiotics can help treat bacterial infections, if the swelling persists despite treatment, it may be necessary to conduct additional tests to determine the exact cause. This could include imaging studies like an ultrasound to assess for abscess formation or other complications.

Regarding your question about continuing the antibiotic regimen, it is crucial to follow your healthcare provider's recommendations. If you have been prescribed antibiotics, it is generally advisable to complete the full course unless directed otherwise by your doctor. However, if your symptoms are not improving or are worsening, it is essential to communicate this to your healthcare provider. They may need to reassess your condition and possibly adjust your treatment plan.

Your concern about whether your immune status is affecting your recovery is valid. Individuals with untreated HIV can have fluctuating CD4 counts, which can lead to an increased risk of infections and complications. The absence of ART can lead to a decline in immune function, making it harder for your body to fight off infections effectively. This is why it is highly recommended for individuals living with HIV to engage in regular medical care and adhere to ART when possible, as this can significantly improve immune function and overall health.

In summary, it is essential to keep in close contact with your healthcare provider regarding your symptoms. Persistent swelling and pain in the testicle, especially in the context of HIV, warrant thorough evaluation. If you experience any new symptoms or if your current symptoms worsen, do not hesitate to seek immediate medical attention. Additionally, consider discussing the importance of starting ART with your healthcare provider, as it can greatly enhance your immune response and overall health outcomes. Your health and well-being are paramount, and proactive management is key to living well with HIV.

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