1556. Retrospective review of gonococcal and chlamydial cases of epididymitis in two Canadian STI Clinics, 2004-2014
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Saturday, October 10, 2015
Room: Poster Hall
Background: Two-thirds of epididymitis among men under 35 years of age are related to sexually transmitted infections (STI). No Canadian data exist on the treatment and outcomes of gonococcal (GC) and chlamydial (CT) infections complicated by epididymitis. Our study sought to examine cases of epididymitis in attendees at two Canadian STI Clinics.

Methods: GC and CT epididymitis cases reported by the Calgary and Edmonton STI Clinics from January 1, 2004 to September 30, 2014 were reviewed. The diagnosis of epididymitis was based on the presence of epididymal swelling and tenderness and/or testicular tenderness. Improved disposition was defined as no worsening of symptoms at the follow-up visit. Treatment failures were defined as those with persistent symptoms requiring additional treatment and no sexual contact between the start of treatment and follow-up visit. Descriptive analysis was completed using IBM SPSS Statistics version 19.0 (IBM, Armonk, NY, USA). Ethics approval was obtained from the University of Alberta’s Health Research Ethics Board.

Results: Fifty-seven cases of epididymitis were reviewed.  The median age was 26 years (IQR: 22-31). The majority of cases were Caucasian (68.4%; n=39) and heterosexual (71.9%; n=41). A total of 73.7% (n=42) of cases were diagnosed with CT alone, 15.8% (n=9) with GC alone and 10.5% (n=6) of cases were co-infected with GC and CT. Three (5.6%) cases were also HIV positive. Most of the cases (57.9%; n= 33) were treated with ceftriaxone 250 mg IM and doxycycline 100 mg bid for 14 days or ciprofloxacin 500 mg single dose and doxycycline 100 mg bid for 14 days (17.5%; n=10). Thirty-five (61.4%) cases returned for follow-up, of which 10 cases (28.6%) had not improved and 4 of these were due to re-exposure. Six cases failed initial treatment; 3 were not treated as per treatment guidelines while 3 were treated as per treatment guidelines.

Conclusion: Epididymitis was an infrequent presenting complication of gonorrhea and chlamydia over a 10 year period in two Canadian STI Clinics.  The majority responded to treatment as per guidelines with 6 treatment failures reported but only 3 among those cases were treated according to guidelines.

Justin Chen, MD1, Jennifer Gratrix, RN, MSc2, Judith Brandley, RN, BN3, Petra Smyczek, MD4, Penny Parker, RN, BN3, Ron Read, MD5 and Ameeta Singh, BMBS, MSc, FRCPC6, (1)University of Alberta Hospital, Edmonton, AB, Canada, (2)Edmonton STD Centre, Alberta Health Services, Edmonton, AB, Canada, (3)Edmonton STI Clinic, Alberta Health Services, Edmonton, AB, Canada, (4)Medicine, University of Alberta, Edmonton, AB, Canada, (5)Medicine, University of Calgary and Alberta Health Services-Calgary STI Clinic, Calgary, AB, Canada, (6)Medicine/Infectious Diseases, University of Alberta, Edmonton, AB, Canada

Disclosures:

J. Chen, None

J. Gratrix, None

J. Brandley, None

P. Smyczek, None

P. Parker, None

R. Read, None

A. Singh, None

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