Promoted SCAFFOLDED->INTEGRATED 2026-05-30. Empty workups[] resolved by adding workup.acute_scrotum (confirmed resolving in clinical-tools-registry.ts line 135; specialty urology+emergency, adapter_id acute_scrotum). Evidence PMIDs PubMed-verified 2026-05-30 — ALL FIVE ORIGINAL PMIDs were fabricated/mis-attributed (33417591=COVID college athletes, 28281491=status epilepticus, 22421094=IOL tilt, 23659871=hypertension-in-pregnancy, 24014292=CLL genomics). Replaced with verified: 34292926 (CDC STI 2021 MMWR), 9889740 (acute scrotal pain review), 32547738 (rare scrotal-pain DDx systematic review), 32214857 (US+UA utility in epididymo-orchitis), 41905882 (adult torsion review). PENDING PRODUCTION: regimen RxCUIs not yet RxNav-revalidated in this pass; inline prose still cites EAU 2017 / Davis 2010 / Barbosa / Friedman tags whose specific PMIDs were unverifiable and were removed from the evidence array — a precision-citation pass is owed before PRODUCTION. shard-3-neuro-sym Phase C wave-9 2026-05-15 — initial author at INTEGRATED depth with full §5.5 contract. 10 acuity / etiology phenotypes encoded as severity_triggers: sti_acquired_younger_men, enteric_pathogen_older_men_or_anal, tubercular_chronic, mumps_orchitis_post_pubertal, brucella_orchitis_endemic, granulomatous_idiopathic, amiodarone_induced, testicular_torsion_pivot_DDx, abscess_complication, chronic_epididymalgia_post_vasectomy. Pivot from sibling rows because per-etiology dossiers do not exist (same engine, different management branch). 5 setting playbooks span the full journey: home (recognition + sexual / instrumentation routing) → outpatient (CDC dual or FQ; 48–72 h follow-up; partner notification) → ed (TWIST + POCUS adjudication of torsion; broad IV abx if admit) → inpatient (IV ceftriaxone or pip-tazo × 48–72 h then PO step-down; total 10–14 d) → icu (urosepsis or Fournier overlap — rare). Empiric STI-suspected (<35): ceftriaxone 500 mg IM × 1 + doxycycline 100 mg PO BID × 10 d (CDC STI 2021); add metronidazole if insertive anal sex. Empiric enteric (≥35, BPH, instrumentation, anal sex): levofloxacin 500 mg PO daily × 10 d OR TMP-SMX DS BID × 10 d (EAU 2017). Torsion pivot mandatory — TWIST score + POCUS Doppler adjudicate; if absent intratesticular flow OR TWIST 5–7 → STAT OR (route to uro.testicular-torsion.v1). Abscess complication → STAT urology drainage + IV broad-spectrum (pip-tazo ± vancomycin). Mumps orchitis (post-pubertal unvaccinated) — supportive only; 30–40% testicular atrophy; bilateral 17% → fertility counsel (Davis 2010). TB / Brucella / granulomatous — ID-directed extended therapy; tissue biopsy often required. Schema-blocked downstream: uro.epididymal-abscess.v1, uro.chronic-epididymalgia.v1, calc.epididymitis_severity, workup.dre_prostate_exam — none yet in clinical-tools-registry.ts. Tickets surfaced in depth brief §11. Multiple PMIDs marked PLACEHOLDER per shard convention; verification required before reconciled stamp canonical. Sibling pivots: uro.testicular-torsion.v1 (highest-stakes DDx — TWIST + POCUS), uro.uti.complicated.v1 (enteric pathogen overlap), uro.prostatitis.v1 (DRE pivot), id.cellulitis.core.v1 (scrotal-wall vs intra-scrotal) — all resolve to real engines in ALL_DOSSIERS. Dossier NOT registered in _registry.ts per shard scope (DO NOT TOUCH _registry.ts). Registration deferred to subsequent commit by shard-0 / cross-shard registry maintainer.