Amiodarone Induced Epididymitis: A Case Report

Abstract

Introduction:Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ventricular fibrillation and atrial fibrillation. Amiodarone creates rarely genitourinary side effects are seen. These are epididymitis, testicular dysfunction and impotance. Amiodarone aggregates and triggers inflammation in the head of the epididym.Case report:We present the case of a patient who developed epididymitis after 17 months of amiodarone therapy, using a low dose (100 mg per day). Although cessation of medication or dose lowering was not performed, remission of the patient only by analgesics is a distinct case reported in urological literature.Conclusions:This case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.

Amiodarone induced epididymo-orchitis

“…After withdrawal of the drug, our patient clinically improved which is consistent with the observation that reducing or withdrawing the drug could alleviate epididymitis 1 , 4 . The pathogenesis of amiodarone induced epididymitis is unknown.…”

“…Causes of epididymitis include post obstructive pathology, post-traumatic, Behcet's disease, Mycobacterium tuberculosis , sexually transmitted infections, gram-negative bacterium, and drug induced 1 . Amiodarone usually causes bilateral testicular involvement and chronic epididymyalgia, in the absence of lever and leukocytosis, which was seen in our patient.…”

“…Orchitis and epididymitis due to amiodarone can also present with a spectrum of clinical presentations. Chronic epididymyalgia in the absence of fever and leukocytosis is the chief symptom of this clinical entity 1 . Non-infectious epididymitis must be diagnosed with a careful medical history to prevent unnecessary antibiotic usage 1 .…”

“…Chronic epididymyalgia in the absence of fever and leukocytosis is the chief symptom of this clinical entity 1 . Non-infectious epididymitis must be diagnosed with a careful medical history to prevent unnecessary antibiotic usage 1 . The purpose of this case report is to show early and clear identification of the toxicity and follow its management.…”

Scrotal pain: Evaluation and management

“…Finally, there has been an association of sterile epididymitis with the antiarrhythmic agent amiodarone in up to 11% of adult patients and rarely in children. The mechanism behind this is unknown but may be related to the accumulation of amiodarone in high concentrations in the testicular tissue [ 24 , 25 ].…”