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[Initial therapy of acute unilateral epididymitis using ofloxacin. I. Clinical and microbiological findings].

In a prospective study, 70 men suffering from uncomplicated acute unilateral epididymitis were treated initially with 2 x 200 mg ofloxacin p.o. per day for 14 days. Patients were reexamined at the end of therapy and again after 6 and 12 weeks. Patients were retreated when the pathogens had not been eliminated. Aetiologically epididymitis was caused in one-third of cases each by C. trachomatis (n = 20) and common urinary tract pathogens (n = 20); in the remaining one-third we found N. gonorrhoeae (n = 1). U. urealyticum (n = 3), or no pathogens (n = 26). At the first check-up examination, in 64/70 patients no pathogens were found. Relevant bacteria were still detected in 6 patients: C. trachomatis in 5 and E. aerogenes in 1. After 12 weeks, infection still persisted in 3 patients (E. coli, P. aeruginosa, enterococci). In vitro the microorganisms were invariably sensitive to ofloxacin. Due to abscess formation, surgical intervention became necessary in 6 patients. In 3 of these cases the causative agent was C. trachomatis. Regardless of the aetiology, after 12 weeks, in 20% of our patients the epididymis was still infiltrated and 14% complained of persistent symptoms.

Acute Disease↗

Methods for control of lamb epididymitis in large purebred flocks.

An autogenous, multivalent, adjuvanted bacterin for epididymitis was tested in flocks of 700 to 800 Suffolk X white-faced lambs. Long-term feeding of low dosages of antibiotics also was tested in the Suffolk flock. Both methods appeared to reduce the incidence of the disease. The incidence of clinical epididymitis and the number of positive culture results from clinically affected rams were significantly reduced.

Actinobacillus↗

[Acute epididymitis in children].

Fifteen cases of epididymitis in children are reviewed, six of these occurring in children under twelve months of age, and nine in older children. In five of the six cases occurring in infants a U.T.I. and a malformation of the urinary tract were found, while in children over one year only three infections and two urinary malformations were discovered. Authors recommend that in infants under 1 year presenting with epididymitis a thorough investigation of the urinary tract is performed.

Acute Disease↗

[Clinical study of norfloxacin in the treatment of acute epididymitis].

The efficacy and safety of Norfloxacin were studied in the treatment of 20 patients with acute epididymitis. Norfloxacin was orally administered at a dose of 200 mg 3 times a day for 14 days. Clinical efficacy rate on the 7th day was 95% (19/20), excellent in 9 cases, moderate in 10 cases and poor in 1 case, and on the 14th day was 95% (18/19), excellent in 12 cases, moderate in 9 cases and poor in 1 case. On the 14th day, fever, pain and swelling had disappeared in 8 cases (in 2 cases on the 7th day). The efficacy on the 14th day was further investigated compared to that on the 7th day. Before treatment with Norfloxacin, in 13 of the 20 patients, pyuria was observed. Cultivating the bacteria was isolated in 4 of the 13 patients. Norfloxacin remarkably affected the treatment of these patients with pyuria and bacteriuria. In the treatment with Norfloxacin, the count of leukocytes, erythrocyte sedimentation rate and CRP were obviously improved. Side effects and abnormal clinical laboratory findings were not observed. From these results, Norfloxacin 600 mg/day, t.i.d was considered useful and safe in the treatment of acute epididymitis.

Acute Disease↗

[Surgical treatment of acute epididymitis].

Epididymotomy was performed besides drug therapy in 61 patients suffering from acute epididymitis. Surgical intervention was indicated if the conservative therapy was not successful or the wall of the scrotum became fixed. Epididymotomy is carried out by longitudinal or multiple incision of the inflamed epididymis and by the drainage of the operative region. Significant advantage of the operation is the rapid recovery and the fact that the development of a not infrequently seen chronic epididymitis can be prevented by it. This not yet widely used method in Hungary is recommended for the treatment of the disease, on the basis of the favourable results of the postexaminations.

Abscess↗

[Case report: an unstable bladder with bilateral epididymitis, urge incontinence and unilateral reflux].

We report a 10-year-old boy with and unstable bladder, bilateral epididymitis, urge incontinence, bed wetting, and unilateral reflux. Previously, he complained of urinary incontinence and was operated on elsewhere with Y-V plasty in the bladder neck and pulling out a balloon catheter through the urethra. Following the surgery the urinary force was weakened, incontinence got worse and bilateral epididymitis broke out frequently. Since the patient was refractory to anti-cholinergic medicine, sacral nerve block, antireflux operation and narrowing the bladder neck were attempted. The surgery was successful in eradicating reflux and urinary tract infection, but failed to normalize the extremely widened bladder neck. Urge incontinence and bed wetting recurred 11 months after the sacral block, which was effective in a selected patient. We believe that Y-V plasty at the bladder neck should not be indicated for a patient with bladder dysfunction closely related to an unstable bladder.

Child↗

[Testicular echography in torsion and epididymitis. Apropos of 2 cases].

We report two cases, one of a long-standing epididymitis with a testicular infarct, the second of testicular tumor with torsion. Scrotal ultra-sound is a quick, easily applied, accurate method to follow cases of subacute epididymitis with atypical evolution. In case of testicular torsion, secondary to tumor, it helps to rule out scrotal exploration and to decide of an orchidectomy with a high located surgical approach.

Adult↗

Comparison and partial characterization of the protein profiles and outer membrane antigens of Actinobacillus species isolated from ram lambs with epididymitis.

Three monoclonal antibodies (LG17, LG30, LG33) were used in the indirect fluorescent antibody test, the ELISA, and the immunoelectrotransfer blot technique to identify group-specific and strain-specific epitopes on the outer membranes of Actinobacillus seminis, A actinomycetemcomitans, and 17 field isolates of Actinobacillus spp. The field isolates had been obtained by bacteriologic culture of specimens from ram lambs with epididymitis. Only antibody LG33 consistently had specificity for an outer membrane epitope shared by most of the bacterial isolates tested. Staining of polyacrylamide gels with periodic acid-Schiff reagent, Sudan black B, and Coomassie brilliant blue R250 indicated that target antigens for antibodies LG17 and LG33 contained carbohydrate and lipoprotein components, respectively. The chemical composition of the LG30 target antigen was not determined because of its instability after exposure to sodium dodecyl sulfate. Discontinuous-gradient polyacrylamide gel electrophoresis in sodium dodecyl sulfate and spectrophotometric scans of the gels were used to analyze n-octyl-beta-D-glucopyranoside protein extracts from A seminis, A actinomycetemcomitans, and 13 representative field isolates of Actinobacillus spp. Bacterial isolates could be grouped according to their protein profiles. The first group consisted of A seminis, A actinomycetemcomitans, and 7 field isolates of Actinobacillus spp, all of which shared common protein bands with molecular masses of approximately 94 kilodaltons (kD), 64 kD, 60 kD, 52 kD, 44 kD, and 26 kD. The second group was composed of 6 field isolates, each with unique protein profiles; isolates had relatively few protein bands in common. These data suggested that members of the genus Actinobacillus cultured from ram lambs with epididymitis probably include a number of various strains.

Actinobacillus↗

An experimental study of the treatment of bacterial epididymitis.

Two groups of rats were treated for epididymitis in an experimental study. The developing infection of E. coli was treated effectively by a single dose of cephalosporin in one group of rats. In the other group, where abscess formation had taken place, no effect of up to 9 days of treatment could be demonstrated, indicating the importance of early antibiotic treatment in bacterial epididymitis.

Abscess↗

Etiologic significance of bacterial isolates from rams with palpable epididymitis.

Identified and partly identified bacterial isolates were obtained from 48 rams of various breeds that had unilateral or bilateral epididymitis. Most of the animals were approximately 1 year of age; a few were older. Brucella ovis, Actinobacillus spp, Corynebacterium spp, Haemophilus spp, Acinetobacter spp, Escherichia coli, Moraxella spp, Staphylococcus spp, Pasteurella spp, Streptococcus spp, and Chlamydia psittaci were isolated. A vaccine strain of B ovis, isolated species of bacteria, and mixtures of isolates of tissue homogenates containing all isolates except B ovis and C psittaci were inoculated via the mucous membranes of the eyes, nares, and prepuce. Palpable epididymitis was not produced by the inoculations. The vaccine strain of B ovis induced complement-fixation reaction in 11 of 20 rams.

Acinetobacter↗

[A case of acute epididymitis in infancy].

We report a 3-month-old boy who presented with acute right scrotal swelling that was diagnosed to have epididymitis at surgical exploration. Urine culture and urinalysis were negative and IVP revealed no abnormality. White blood count and symptom were improved with chemotherapy. Acute epididymitis in infancy is very rare and this case seems to be the 16th case in Japan.

Acute Disease↗

[Effect of cefoperazone on acute prostatitis and epididymitis].

Cefoperazone (CPZ) was intravenously administered to rabbits and the concentration of CPZ in the accessory male genitals was determined. The epididymis, prostate and testicles had a high enough concentration of CPZ to kill various kinds of bacteria. Therefore, CPZ was applied to 11 clinical cases of acute epididymitis and 4 cases of acute prostatitis, but clinical effects were not so satisfactory in the cases of acute epididymitis.

Acute Disease↗

[Serum sialic acid levels in patients with acute prostatitis or acute epididymitis].

The serum sialic acid concentration in 17 male healthy adults, 11 patients with acute prostatitis and 12 patients with acute epididymitis was measured with a specific enzymatic assaykit. The concentration was studied in relation to erythrocyte sedimentation rate, total serum protein and its fraction, C-reactive protein, and white blood cell count. Blood samples were obtained from the patients immediately before antimicrobial chemotherapy and the subsequent 3, 5, 7, 14, and 28 days. The pretreatment sialic acid concentration in the patients was significantly greater than that in the control subjects (P greater than 0.001). The mean serum sialic acid concentration in the patients reached a maximum level 3 days after the beginning of the treatment, and then gradually decreased. There was a significant correlation between the daily change of the serum sialic acid level and those of the erythocyte sedimentation rate, alpha2-globulin, and alpha1-globulin. Serum sialic acid proved to be a useful biochemical marker in acute prostatitis and acute epididymitis.

Acute Disease↗

Association of age of ram with distribution of epididymal lesions and etiologic agent.

A 2-year study of the frequency of isolation of various organisms from mature and yearling rams with epididymitis was conducted at the US Sheep Experiment Station at Dubois, Idaho. Investigation into the distribution of lesions in the epididymis in relation to age of the ram also was studied. Serologic or bacteriologic evidence of Brucella ovis infection was demonstrated in 79.5% of the mature rams with epididymal lesions. Actinobacillus seminis and Histophilus ovis were the 2 most frequently isolated organisms from yearling rams with lesions. The tail(s) of the epididymis was the most frequent site of lesion development in the mature rams (86.4%). Yearling rams developed lesions twice as frequently in the tail(s) of the epididymis as in the head(s) of the epididymis. When lesions were localized in the head(s) of the epididymis, an etiologic agent usually was not demonstrated.

Actinobacillus↗

Detection of antibody in rams with contagious epididymitis, using the enzyme-linked immunosorbent assay.

An enzyme-linked immunosorbent assay, using whole-cell and sonicated antigens prepared from Brucella ovis, Actinobacillus seminis, and Actinobacillus seminis-like cultures isolated from rams in Wyoming, was able to detect antibody to these antigens in rams with epididymitis. The whole-cell antigens used in this procedure gave lower background values, compared with those of the sonicated antigens. The procedure was able to detect antibody in rams before clinical signs of epididymitis became apparent.

Actinobacillosis↗

Bacterial isolates associated with epididymitis in rams from Idaho and eastern Oregon flocks.

Testicles from 47 rams with palpable lesions of epididymitis were subjected to bacterial culture. Of the testicles examined by culture technique, 49% were positive for bacterial growth. The 2 most frequent isolates were Actinobacillus actinomycetemcomitans (23.4% of the testicular pairs) and Brucella ovis (14.9% of the testicular pairs). Heretofore A actinomycetem-comitans has not been reported as a cause of epididymitis in rams.

Actinobacillus↗

[The effect of cefmetazole in the treatment of acute prostatitis and acute epididymitis].

Cefmetazole (CMZ) was intravenously injected to 12 patients with acute prostatitis as well as 3 patients with acute epididymitis. Good clinical results were obtained in 10 patients (91.7%) with acute prostatitis and 2 patients (100%) with acute epididymitis. No side effects were reported in all of 23 patients. Thus, CMZ could be expected to reveal good response in the treatment of male genital infections.

Acute Disease↗

[Diagnosis and therapy of epididymitis].

140 patients with acute epididymitis were observed between 1979 and 1983 in the Department of Urology of Bundeswehrkrankenhaus Hamburg. The diagnostic measures and therapy were done by standardized criteria. When the first therapeutic regimen was finished 75 of 140 patients (54%) were reinvestigated and treated when necessary. In acute epididymitis infiltration of the spermatic cord with local anaesthesia, suspension and cooling of the testis and broad-spectrum antibiotics for several days are recommended. Effective treatment depends on precisely selected diagnostic parameters which should concentrate on bacteriological and immunochemical investigation of urine and semen and include clinical and radiological examination of the lower urinary tract.

Acute Disease↗