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. 2018 Apr 10;24(4):416–441. doi: 10.1093/humupd/dmy009

Table I.

Classification of human epididymitis and orchitis according to etiological factors and pathomechanisms.

Etiology Main factors Patho-mechanism Clinical manifestation
Microorganisms

  • Bacteria

  • Uropathogens (Escherichia coli, Entero-bacteriaceae spp. and others); sexually transmitted infections (Chlamydia trachomatis, Neisseria gonorrhoeae and others)

 Ascending, canalicular infection Epididymitis/Epididymo-orchitis
Mycobacterium tuberculosis, M. leprae, Treponema pallidum, Brucella spp. Canalicular and/or haematogenous infection

  • Orchitis (predominantly granulomatous),

  • Epididymitis

  • Viruses

  • mumps virus, Coxsackie virus types, Epstein-Barr, influenza, varicella, human immunodeficiency viruses and others

 Haematogenous infection Orchitis
Adenovirus, Enterovirus Epididymitis

  • Fungi

  • Candida albicans, Histoplasma capsulatum

 Ascending, canalicular infection Epididymitis

  • Parasites

  • Trichomonas vaginalis

 Epididymitis
Schistosoma spp., Filariasis
Chemical noxae Drugs (e.g. Amiodarone); heavy metals (e.g. mercury compounds) ?

  • Epididymitis,

  • Orchitis
Physical factors Genital trauma, vasectomy Obstruction Chronic Epididymitis
Unknown Systemic disease Morbus Behcet, systemic lupus erythematosus, Schönlein-Henoch purpura and other vasculitic disorders Autoimmune inflammation

  • Orchitis,

  • Epididymitis
‘Idiopathic’ Autoimmune inflammation?

  • Idiopathic epididymitis

  • Idiopathic granulomatous orchitis