A 16-year-old boy presents with sudden onset severe left testicular pain that started 3 hours ago while playing football. The pain is constant and associated with nausea. He has no dysuria or urethral discharge.
On examination:
- Left testis: swollen, tender, high-riding, horizontally oriented
- Absent cremasteric reflex on left side
- Right testis: normal
Observations:
- BP: 118/72 mmHg
- HR: 98 bpm
- Temperature: 36.8°C
Urinalysis: No blood, no leucocytes, no nitrites
What is the MOST appropriate immediate management?
A
Arrange immediate surgical exploration
B
Manual detorsion and outpatient urology follow-up
C
Commence IV antibiotics and arrange urology review
D
Reassure and discharge with oral analgesia
E
Arrange urgent Doppler ultrasound of testes