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A 69-year-old man complained of a painless left scrotal swelling. The scrotal mass was enlarged to a hen's egg size with a smooth surface. The scrotal ultrasonogram showed diffuse hypoechogenicity. A testicular tumor was suspected and left high orchiectomy was performed. Histopathological diagnosis was granulomatous orchitis.
During the eradication of Brucella ovis infection from five large breeding ram flocks of Sub-Carpathia (The Ukraine), the genital organs of 55 rams culled because of seropositivity in the agar-gel precipitation (AGP) test and ELISA were subjected to gross pathological, histopathological and bacteriological examination. The results of these examinations, as well as the properties of B. ovis strains isolated for the first time in the region are reported. Thirty-three out of the 55 pairs of epididymides and testicles (60%) showed gross lesions (chronic epididymitis associated with the formation of spermatocele, sperm granuloma or abscess). From the 55 pairs of epididymides and testicles examined, a total of 26 B. ovis strains were isolated: of them, 24 (92.3%) originated from breeding rams while 2 (7.7%) from ram hoggets kept together with the breeding rams. Seven out of the 26 B. ovis strains (26.9%) were cultured from the epididymides of rams which did not show palpable epididymal and/or testicular lesions. It is emphasized that chronic inflammatory processes were observed in both epididymides even if the clinically palpable epididymo-orchitis occurred unilaterally. Three out of the 26 B. ovis strains were derived from AGP-positive but ELISA-negative, while 5 from ELISA-positive but AGP-negative rams. The remaining B. ovis strains were isolated from the genital organs of rams found seropositive both by the AGP test and by ELISA. The cultural, morphological and most important biochemical properties of the 26 sub-Carpathian B. ovis strains were identical with those of the reference strain designated Weybridge 63/290 (NCTC 10512).
Testicular microlithiasis, also referred to as intratubular testicular calcification, is an uncommon urological curiosity of unknown aetiology. A case of epididymo-orchitis occurring in microlithiasis is reported and their possible association is discussed.
Idiopathic granulomatous orchitis is a rare testicle lesion of unknown etiology. This paper illustrates 10 cases studying their presentation, location, ultrasound and histological diagnosis and therapy. A testicular injury background and self-immune reaction appear as likely causes of this entity. Differential diagnosis with testes malignant tumours can only be reached after orchiectomy and a subsequent histological examination.
A retrospective study of orchiepididymitis, diagnosed and admitted to our Unit over the 1989-94 period was conducted. there were 125 orchiepididymitis, of which 16 (12.8%) had a brucellar etiology, and three had simultaneously become abscessified (18.75%). Considering that our working area is located within an endemic region, and even more, our province has the country's highest incidence rate (112.8/100000 inh.), this prompted us to study the conditions' morbidity in the testicular location, while we make a superficial revision of this disease. Brucellar orchitis is a diagnostic option to be taken into account in endemic regions, and the clinical picture associated to the orchiepididymal process should make us suspect its diagnosis and trigger follow-up of these patients.
The study presents results of an investigation on male fertility after mumps infection without clinically manifested mumps orchitis. The study included 30 patients, but 10 were excluded because of other ethnologic factors connected to male infertility. Out of 20 patients 12 were fertile, while 8 were subfertile. All of these 8 subfertile patients were with asthenospermia, that is with decreased sperm motility.
We report a rare case of suppurative epididymo-orchitis caused by Pseudomonas pseudomallei in a 56-year-old male. This is a gram negative bacillus found mainly in tropical zones. Diagnosis was reached by culture of the organisms after drainage of the scrotal abscess, and the patient was treated by a course of oral chloramphenicol 500 mg qid for 6 months.
Epididymo-orchitis (EO) is said to be extremely rare in infants and children. It is usually diagnosed after scrotal exploration for symptoms which mimic manifestations between EO and torsion of the cord and its appendage. The pathophysiologic mechanisms for the development of EO are not well known. Although some causative agents of EO have been reported, in most cases there was no clear etiology. We report a 3-month-old male infant who had been well until the day prior to admission when irritability, left testicular swelling, scrotal erythema with a hot sensation were noted by his mother. He was treated medically after excluding the possibility of an emergent surgical condition (such as torsion of the cord and its appendage, or incarcerated hernia) by means of physical examinations, abdominal and inguino-scrotal sonography, laboratory studies, and testicular radionuclide scintigraphy. A catheterized sample of urine for culture yielded Escherichia coli. There was the possibility that the EO was caused by hematogenous rather than local spread from an infection of the urinary tract. He was treated with a 10-day course of intravenous cefazolin and amikacin. Following this, he improved clinically and a repeat catheterized urine sample remained sterile on culture. In addition, a bilateral inguinal hernia and hydrocele were detected by inguino-scrotal sonography and were operated on the 11th hospital day. He was discharged on the 16th day of hospitalization and remained well 11 months after discharge.
Previous studies have shown that differential susceptibility to actively induced experimental allergic encephalomyelitis (EAE) and experimental allergic orchitis (EAO) exists among various BALB/c substrains. Of eight substrains studied for EAE and 13 for EAO, BALB/cJ mice are phenotypically the most resistant to disease induction. Resistance to both diseases is controlled by single recessive mutations unlinked to any of the known alleles distinguishing BALB/cJ mice. In this study, segregation analysis employing a second generation backcross population shows that resistance to both EAE and EAO is due to a mutation in a common immunoregulatory gene. The role of immunoregulatory cells in controlling EAE resistance was examined using adoptive transfer protocols. BALB/cJ mice immunized with spinal cord homogenate plus adjuvants generate immunoregulatory spleen cells (SpC) that, when transferred to naive BALB/cByJ recipients, reduce the incidence and severity of EAE. Treatment of such cells with either cytotoxic monoclonal anti-Thy1.2 or anti-CD4 plus C' before transfer abrogates the ability of BALB/cJ SpC to inhibit disease. In contrast, neither SpC from adjuvant-immunized BALB/cJ nor spinal cord homogenate- plus adjuvant-primed BALB/cByJ donors influences the incidence or severity of disease observed in recipients. In addition, the role of environment in influencing susceptibility to EAE and EAO in BALB/c mice is documented. Taken together, these results support the existence of a common disease susceptibility locus in the pathways leading to two autoantigenically distinct CD4+ T cell-mediated, organ-specific, autoimmune diseases.
Tuberculosis can involve the genitourinary tract and may be the sole manifestation of this disease. We herein report a case of tuberculous epididymo-orchitis. Based on our experience and a review of the literature, we feel prompt management and heightened awareness of those patients most prone to genitourinary tuberculosis is necessary with the increasing incidence of this disease.
Epididymo-orchitis in the elderly is usually associated with urinary tract infections, prostatitis, and urethral manipulations. It usually presents as acute scrotal pain, and specific complaints direct further exam and work up. As persons with dementia are unable to give a history or localize pain, it can be overlooked. It mimicked as hip fracture in the case presented here.
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