40 year old man is suffering from fever & pain in the scrotum which is not relieved by elevation of testis. 3 days before he had sexual contact with a young female :
**Core Concept**
The patient's symptoms are suggestive of epididymitis, an inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm. This condition is often caused by a bacterial infection, which can be sexually transmitted.
**Why the Correct Answer is Right**
The patient's symptoms, including fever and pain in the scrotum not relieved by elevation of the testis, are consistent with epididymitis. The fact that he had sexual contact with a young female 3 days prior to the onset of symptoms increases the likelihood of a sexually transmitted infection (STI) causing the epididymitis. STIs such as chlamydia and gonorrhea are common causes of epididymitis in young men.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because epididymitis typically presents with pain and swelling in the scrotum, not in the groin or testicle alone.
**Option B:** This option is incorrect because epididymitis is not usually associated with a mass or nodule in the scrotum.
**Option C:** This option is incorrect because epididymitis is not typically caused by a viral infection, but rather by a bacterial infection.
**Clinical Pearl / High-Yield Fact**
In cases of epididymitis, it is essential to consider the possibility of a sexually transmitted infection and to obtain a thorough sexual history from the patient. A urinalysis and culture can also help identify the underlying cause of the epididymitis.
**Correct Answer:** C.