1) Acute epididymitis – painful swelling of epididymis, tender swelling of epididymis, unilateral testicular pain, tender testes, hydrocele, palpable eoididymis, tendere swollen spermatic cord, in sexually active males associated with asymptomatic urethritis, but laboratory evidence of urethritis seen, non-STD epididymitis is associated with UT instrumentation, surgery, systemic disease, immunosuppression, Gram stain of urethral secretions show more than 5 WBC per oil immersion field, WBC with gram negative intracellular diplococci in case of gonococcal infection, first void urine leucocyte esterase test positive, first void urine sediment microscopy shows more than 10 WBC high power field, urethral swab specimens for culture of N. gonorrhoeae and C. trachomatis positive if acute epidicymits is of STD origin, color duplex doppler ultrasonography sensitivity 70% specificity 88%, Tx – for gonococcal or chlamydial infections Ceftriaxone 250 mg IM single dose AND Doxycycline 100 mg PO bid for 10 days, bed rest, scrotal elevation, analgesics, for epididymitis due to enteric organisms Ofloxacin 300 mg PO bid for 10 days OR Levofloxacin 500 mg PO once daily for 10 days, partner evaluation and treatment if sexual contact with the patient within 60 days of symptom onset. Failure to improve within 3 days requires a re-evaluation of diagnosis and treatment.