A 60-year-old man with a history of nodular prostatic hyperplasia and recurrent cystitis presents with pain in the scrotum. His temperature is 38degC (101degF). Physical examination reveals a small, tender nodule attached to the testis. Which of the following is the most likely diagnosis?

Epididymitis is an inflammation of the epididymis, usually caused by bacteria, which may be acute or chronic. Bacterial epididymitis in young men most often occurs in an acute form as a complication of gonorrhea or as a sexually acquired infection with Chlamydia. It is characterized by suppurative inflammation. In older men, E. coli from associated urinary tract infections is the most common causative agent. Patients present with intrascrotal pain and tenderness, with or without associated fever. Varicocele (choice E) is incorrect because it does not typically present with pain and fever. Neither orchitis (choice B) nor urethritis (choice D) would present with a nodular scrotal mass.Diagnosis: Epididymitis