Recognize the most common cause of epididymitis in men over age 35.

Explanation:

It is somehow felt that men over 35 do not get into the high risk situations to contract Gonorrhea or Chlamydia but they instead get hit by Enterobacteriaciae(GNRs). They are empirically treated with Ciprofloxacin but always remember to rule out GC and Chlamydia- so obtain the test but empirically treat for GNRs.

Men <35 on the other hand are commonly infected with GC and Chlamydia thus investigate but empirically treat with Ceftriaxone(for GC) 125 mg x 1 dose IM + Doxy(for Chlamydia) 100 bid X10 days or use single drug therapy with one dose Azithromycin-2gm or Ofloxacin x 10 days.