An Adolescent Male Reports Severe Pain in One Testicle

An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention?

A) Doppler ultrasound to assess testicular blood flow
B) Immediate referral to the emergency department
C) Prescribing anti-infective agents to treat the infection
D) Transillumination to assess for a "blue dot" sign