Family Nurse Practitioner Exam

What is the most likely diagnosis for a 10-year-old boy with sudden onset of left scrotal pain and negative urine dipstick results?

1. Acute epididymitis

2. A severe salmonella infection

3. Testicular torsion

4. Acute orchitis

The correct answer is: Testicular torsion

The most likely diagnosis for a 10-year-old boy presenting with sudden onset of left scrotal pain, particularly when accompanied by negative urine dipstick results, aligns best with testicular torsion. This condition is characterized by the twisting of the spermatic cord, which can occlude blood flow to the testis and leads to acute, severe pain. The age of the patient is also a relevant factor, as testicular torsion typically occurs in prepubescent and adolescent boys. The abrupt nature of the pain, as opposed to a gradually worsening condition, is a strong indicator of torsion. In this scenario, the negative urine dipstick results suggest that urinary tract infection or epididymitis is unlikely, as these conditions often present with accompanying urinary symptoms or findings. Other conditions, such as acute epididymitis, tend to present with more gradual onset of pain and often include urinary symptoms or dysuria. Acute orchitis, which may present with scrotal pain, is usually accompanied by fever or systemic signs, and also may have associated history of viral infection. A severe salmonella infection could lead to gastrointestinal symptoms and is less likely to manifest as isolated scrotal pain. Therefore, the sudden onset of intense pain in