5th May 2024

A 25-year-old man presents with a 3-day history of pain and swelling in his left testicle.

A 25-year-old man presents with a 3-day history of pain and swelling in his left testicle. He reports a low-grade fever and a burning sensation during urination. He is sexually active with multiple partners and does not consistently use condoms. On examination, his left testicle is swollen, tender, and elevated. The cremasteric reflex is present. Urinalysis shows leukocyte esterase positivity, but no bacteria. His temperature is 37.8°C.

Which is the most appropriate initial treatment?