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What causes pain and tenderness in perineum afte fever?

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General & Family Physician
Practicing since : 1992
Answered : 621 Questions
Hi there, I am a 28 year old male, Caucasian, and about two weeks ago(on a Sunday) I started to feel achy and figured I had a cold coming on. I ran a low grade fever for the next couple of days(99 - 100.5)and decided to go back to work and finish the week out. Well, on that Friday, sitting at my desk I noticed pain and soreness coming from the lower part of my scrotum area, I didn't think much of it at the time, I figured maybe hemorrhoids. Well this last weekend my fever, aches, and chills came back again and I went to a clinic on Monday. My temp was just over 100 and the doc noticed some Thrush on my tongue and noted some pain and tenderness in the sinus region and diagnosed that it was likely Sinusitis (Something I've dealt with many times). She prescribed Amoxicilin and an oral rinse for the thrush. I didn't really mention the perineum soreness. What has happened since that visit is what concerns me the most, I'm getting fever in waves, some parts of the day I'm fine but then around bedtime my temp will soar again(up to 103 at times) only to have come back down again in the morning! What has remained constant is that my perineum is very tender and sore to the touch, I feel it most during bowel movements, or coughing, or when I am shifting around while sitting which of course puts pressure on that area. I've been doing research all morning and Prostatitis, or some bacterial infection of the prostate has me extremely worried. I don't have any urination difficulty, and haven't noticed any particular pain during or after ejaculation, but as tender as this area is I want to be very careful. Can you help me?
Posted Fri, 21 Feb 2014 in General Health
Answered by Dr. Behar Greca 1 hour later
Brief Answer: Orchitis is your problem... Detailed Answer: Hi, thank you for posting. Infection caused by cold has caused a complication of perineum. More exactly I think that it is orchitis disease. The condition of your disease makes me think that the main cause is Mumps(viral infection of parotis gland). There is a relation between Orchitis and Mumps. Of course there are a lot causes, but more frequent are bacterial infection. To determine the diagnose you need: -Blood test. -Urine test. -Scrotum echography. To treat orchitis I usually recommend Azithromycin 250mg. First day, Azithromycin 250mg 2 pills a day. The next four days, Azithromycin 250mg 1 pill a day. This treatment continues only for 5 days. Of course, there are other alternatives with medicines, dependent on the results of tests. I suggest you to contact an urologist. For anything unclear, you can ask me. Dr. Behar.
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