1. CASE PRESENTATION ON ORCHITIS

2. Name: Mr. X
Sex: Male
Age: 54 years DOA: 24/10/13
Weight: 60kg
Chief Complaints:
Severe testicular pain radiating to the
abdomen
C/O vomitting.
C/O
History of Present Illness:
H/O left abdominal pain
H/O decreased appetite
Past Medical History:
K/C/O
DM 15 Years

3. Past Medication History:
Metformin-500mg,glimepiride-1mg,
Underwent surgery for right inguinal hernia since 5 years
before
Social History :
Non-Smoker, non-alcoholic, married
Physical Examination:
Patient is conscious/ oriented.
No Pallor, cyanosis, clubbing.
Normal lymph nodes.
On Examination:
Temp: Afebrile
B.P: 120/80mmHg Pulse: 80/min
System Examination:
CVS: S1S2+,
RS: NVBS
CNS: NFND
P/A: Soft, Painful

4. LAB INVESTIGATIONS
PARAMETER
OBSERVED VALUE
NORMAL RANGE
Hemoglobin
14.8g/dl
14-18g/dl
RBC
4.7millions/mm3
4.5-5.6million/mm3
ESR
21mm
5-15mm
PCV
47%
45%
DC
N-85%
Total WBC
13500cells/mm3
4000-11000 cells/mm3
MCV
91.6
80-96fl/red cells
MCH
30.2
26-33pg/cells
MCHC
33
31-36g/dl
Platelet
2,45,000cells/mm3
1,50,0004,00,000cells/mm3
Blood sugar(FBS)
202
60-100
L- 35% E-2%
N-40-75% L-30-50%
E-2-6%

5. PARAMETER
OBSERVED VALUE
NORMAL RANGE
BUN
22mg/dl
8-23mg/dl
Creatinine
0.8mg/dl
0.6-1.2mg/dl
Sodium
135mmol/l
135-147mmol/l
Potassium
4.8mmol/l
3.5-5.2mmol/l
Chloride
98mmol/l
95-107mmol/l
Bicarbonate
22mmol/l
22-30mmol/l
Total Bilirubin
0.7mg/dl
0.3-1.0 mg/dl
Direct Bilirubin
0.3 mg/dl
0.1-0.3 mg/dl
Indirect Bilirubin
0.4 mg/dl
0.2-0.7 mg/dl
Renal Function Tests:
Liver Function Tests:

6. PARAMETER
OBSERVED VALUE
NORMAL RANGE
SGOT
22U/L
12-38U/L
SGPT
34U/L
7-41U/L
Albumin
4.3g/dl
3.5 – 5.3 g/dl
Globulin
2.2g/dl
2-3 g/dl
Total protein
6.5g/dl
5.5-9.0 g/dl
Alkaline phosphatase
228U/L
84-306 U/L
Gamma GT
28 U/L
5-50 U/L
Prothrombin time
14 seconds
10-15 seconds
Urine analysis:
Colour
yellow
pH
6.0
Epithelial cells
0-2
Protein
Trace

7. OTHER INVESTIGATIONS
Visible swelling of the testicles
Culture sensitivity:
Specimen: Urine - Growth observed (Culture positive)

Urine acetone –negative
 Bleeding time -1’ 55’’
 Clotting time 4’00’’
 HbA1c: 7.2
 USG Colour Doppler:


Impression: Normal spermatic cords.
 Normal blood flow to both the testicles was observed.

8. Diagnosis: Orchitis
Drug chart:
Drugs
Dose
ROA
Frequency
No. of Days
Glibenclamide+
Metformin
2.5mg+
400mg
P/O
BD
X1
Imipenem Cilastatin
1g
IV
TDS
X3
Ondansetron
4mg
P/O
BD
X3
Rantitidine
2ml
IV
TDS
X3
Otilinium bromide
60mg
P/O
BD
X2
T. Gelusil
P/O
BD
X3
T. B complex
P/O
OD
X3
Metformin
500mg
P/O
BD
X 2 (Continued
Human Lispro Insulin
30U
SC
OD
X 2 (Continued

9. DISCHARGE ADVICE:
1. T. Metformin – 500mg – 1-0-1
2. Human lispro – 1-0-0 (30U)

10. THANK YOU