In epididymitis among men over 40, the usual pathogens are from which category?

In epididymitis among men over 40, the usual pathogens are from which category?

• A. Gonorrhea or Chlamydia
• B. Escherichia coli
• C. Gram-negative rod from UTI or prostatitis
• D. Streptococcus agalactiae

Answer: (C)

In men over 40, epididymitis is most often due to urinary tract–origin bacteria that ascend to the epididymis. These are Gram-negative rods commonly linked to UTIs or prostatitis, such as E. coli and related Enterobacteriaceae. This category fits best because it reflects the typical source and type of organisms in this age group, unlike younger men where sexually transmitted pathogens like gonorrhea or chlamydia are more common. Streptococcus agalactiae is not the usual offender in this demographic.

In men over 40, epididymitis is most often due to urinary tract–origin bacteria that ascend to the epididymis. These are Gram-negative rods commonly linked to UTIs or prostatitis, such as E. coli and related Enterobacteriaceae. This category fits best because it reflects the typical source and type of organisms in this age group, unlike younger men where sexually transmitted pathogens like gonorrhea or chlamydia are more common. Streptococcus agalactiae is not the usual offender in this demographic.