Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What are the common causes of left testicle pain?
Can a varicocele cause pain in the left testicle?
Should I be concerned about sudden and severe left testicle pain?
Is left testicle pain related to kidney stones?
How is left testicle pain diagnosed and treated?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hi, I'm Cody, your AI doctor. I see you're experiencing some pain in your left testicle. Can you tell me more about it?
Patient
Sure, the pain started about three days ago. It's sharp and moderately severe.
Cody, the AI Doctor
Thanks for sharing that. When the pain started, was it sudden or did it come on gradually?
Patient
It started suddenly.
Cody, the AI Doctor
I see. On a scale of 1 to 10, with 1 being no pain and 10 being unbearable, how would you rate your pain?
Patient
I’d say it’s about a 6 or a 7.
Cody, the AI Doctor
Understood, that sounds pretty uncomfortable. Have you noticed any other symptoms, such as swelling or redness in the area?
Patient
Yes, there’s been some slight swelling, but no redness. I also have some vague burning when I pee.
Cody, the AI Doctor
Alright. Have you experienced any fever or chills? Or any blood in your urine?
Patient
No, none of that.
Cody, the AI Doctor
Got it. You mentioned no blood in your urine, but you occasionally have a vague burning sensation when urinating. Is that correct?
Patient
Yes, that’s right.
Cody, the AI Doctor
Thank you for clarifying. Are you sexually active?
Patient
Yes, I am.
Cody, the AI Doctor
Have there been any recent changes in your sexual activity or new partners?
Patient
No, nothing new or different.
Cody, the AI Doctor
Thank you. You mentioned taking over-the-counter pain medications like Tylenol with only mild improvement. Is that correct?
Patient
Yes, it helps a bit but doesn’t completely relieve the pain.
Cody, the AI Doctor
Understood. Have you taken up any new activities or sports lately?
Patient
No new sports. But I did start riding my bike to work.
Cody, the AI Doctor
Understood. How long have you been riding the bike?
Patient
About a couple of weeks now.
Cody, the AI Doctor
Do you typically experience any discomfort while biking?
Patient
Sometimes, but nothing major. Just the usual soreness from riding.
Cody, the AI Doctor
Thank you for this detailed information. I’m almost ready to provide a summary and our top three potential diagnoses. Could you tell me if you’ve ever had any similar issues in the past?
Patient
No, this is the first time I’ve had this kind of pain.
Cody's AI Summary
- You are a 24-year-old man pain in your left testicle which began suddenly three days ago.
- The pain causes nausea and is associated with slight swelling and a vague burning sensation during urination.
- You deny having fever, chills, or blood in your urine.
- Over-the-counter medications provide only mild relief.
- You are sexually active with no recent changes in sexual activity.
- You have recently started biking to work with a new bike.
- No previous history of similar pain.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Epididymitis(50% probability)
An inflammation of the epididymis (a narrow, tightly coiled tube attached to the back of each testicle that stores sperm), often caused by infection. It presents with sudden testicular pain, swelling, and sometimes a burning sensation during urination. Recent sexual activity raises the likelihood of an underlying infection.
2. Orchitis(30% probability)
An inflammation of one or both testicles, potentially caused by bacterial or viral infection. Symptoms include testicular pain, swelling, and nausea. While less common without a significant fever or chills, it remains a consideration.
3. Testicular Torsion(20% probability)
A medical emergency where the testicle twists, cutting off its blood supply, leading to sudden severe pain and swelling. The sudden onset of pain points to this possibility, but the lack of significant swelling decreases its likelihood. Immediate medical attention is recommended to rule out conditions like testicular torsion that require urgent intervention.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
In reviewing the patient’s history and symptoms,
1. Epididymitis (50% probability)
With a probability of 50%, epididymitis is the most likely diagnosis. This condition often presents with symptoms such as sudden testicular pain, swelling, and burning sensation during urination, which matches the patient's symptoms. The patient's sexual activity increases the risk of sexually transmitted infections, a common cause of epididymitis.
2. Orchitis (25% probability)
At 25% probability, orchitis is less common without systemic symptoms such as fever, chills, or malaise. However, bacterial or viral infections could still be the cause. Orchitis should be considered, especially if there's progression in the symptoms.
3. Testicular Torsion (25% probability)
Testicular torsion is a medical emergency that needs to be ruled out immediately. The sudden onset of pain and moderate severity aligns with the presentation of torsion, but the only moderate pain and swelling suggests it may not be torsion. However the new bike riding increases the chances of torsion.
Next Steps for Evaluation
Immediate Evaluation: A physical examination and scrotal ultrasound are imperative to rule out testicular torsion. That is the first step. The exam and ultrasound will also help diagnose epididymitis and orchitis. But the key is to rule-out torsion.
Urinalysis: To check for signs of urinary infection.
Sexually Transmitted Infection (STI) Testing: Given the sexual history, testing for common STIs, such as gonorrhea and chlamydia, should be done to identify potential causes of epididymitis or orchitis.
Pain Management: Continue with pain management using NSAIDs and consider antibiotics if an infection is suspected while awaiting the results of the urine and STI testing.
Potential Treatment Modalities
The first-line therapies for each condition are:
Epididymitis: Antibiotics: Administer appropriate antibiotics based on the suspected causative organism (typically ceftriaxone and doxycycline for sexually transmitted causes, or levofloxacin for non-sexually transmitted causes). Then implement Supportive Care: Use of analgesics (pain relievers) and anti-inflammatory medications. Finally, Rest and Scrotal Elevation: Recommending bed rest and elevating the scrotum to reduce swelling.
Orchitis: Antibiotics: If caused by bacterial infection, administer antibiotics as per the identified organism. Pain Management: Use of analgesics and anti-inflammatory drugs to relieve pain. Supportive Measures: Rest, ice packs, and scrotal support to alleviate discomfort and swelling.
Testicular Torsion: Perform urgent surgical intervention (detorsion) to restore blood flow and viability of the testicle.
Resource Center
Testicle Pain Resources
Related Articles
Related Articles
Testimonials
Dr Cody spot on, better than most Human Drs. Also far more pleasant. Try him, he could better help you understand your issues. He will give you good info for your Drs visit as well.
TrustPilot Review
Directions provided by Cody with every chat helped to proceed effortlessly.
TrustPilot Review
Genuinely saved my life. I went to an Instacare for severe abdominal pain and was told to take Tums for the next two weeks. I left feeling rushed out and unheard. I wrote out my symptoms to CodyMD and was told there’s a 75% chance I have acute appendicitis. I took myself to the hospital and had emergency surgery the same morning.
TrustPilot Review
