SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Two cases of adverse reactions to intravesical treatment with bacillus Calmette-Guérin are reported. The first patient presented with a severe suppurating epididymo-orchitis three months after his last treatment. The second patient developed Reiter's disease with arthritis of one knee and conjunctivitis 1 week after the fourth instillation.
The effects of antigenic competition between ovalbumin and sperm autoantigens have been studied in guinea pigs. There was an inhibition of antiovalbumin antibody production up to 60 days after immunization. The cell-mediated immunity against ovalbumin was also depressed at day 30. The simultaneous immunization with both antigens has no effect upon the humoral and cell-mediated immunity against spermatozoa. During the period of inhibition of the humoral and cell-mediated antiovalbumin response, the number of animals developing autoimmune aspermatogenic orchitis was diminished compared to those immunized with spermatozoa alone. Later on, there was no difference between the two groups. The transient inhibition of the immune response against ovalbumin can be explained by the particulate nature of the autoantigens. The sperm cells may be easily trapped by the dendritic reticular cells of the draining lymph nodes. This in turn could affect T cell recognition at early stages, orienting it predominantly toward the sperm autoantigens. At day 90 the situation returned to that present in animals immunized with ovalbumin alone.
Autoimmune diseases can affect the blood vessels, causing systemic vasculitis. Although testicular manifestation of some autoimmune diseases is not uncommon, only a few cases of acute orchitis are described in the literature. The underlying pathological condition in testicular manifestations of autoimmune diseases is severe vasculitis causing inflammation and infarction. In patients with recurrent episodes of scrotal swelling and pain, testicular vasculitis as the first sign of a systemic disease should be taken into consideration.
Active experimental allergic orchitis (EAO) was induced in Lewis/NCr rats by immunization with homologous rat testicular homogenate. Groups of animals were studied sequentially at five day intervals for histopathologic signs of disease. Inflammatory lesions were first observed in the ductus efferentes as early as 5 days following immunization. Immunohistochemical analysis of the testes, rete testis, ductus efferentes and caput, corpus and cauda epididymis of immunized rats on day five revealed that only the ductus efferentes exhibited a significant increase in the number of interstitial cells expressing Ia antigens (MRC OX-6) as well as CD4 (W3/25) positive helper/inducer T lymphocytes, CD8 (MRC OX-8) positive cytotoxic T lymphocytes and/or natural killer cells and macrophages (MRC OX-42). Increased staining for Ia antigens was also associated with both the vascular and ductal epithelial cells whereas cells within the lumen of the ducts were consistently negative for Ia antigen expression. In contrast, there was no detectable increase in the level of expression of rat MHC class I antigens (MRC OX-18) by any of the cells of the ductus efferentes. Similarly, there was no increase in the number of MAR 18.5 and/or MRC OX-12 positive B lymphocytes. By day 15, autoimmune epididymitis was observed in the cauda and corpus epididymis with the caput becoming involved by day 20. In the testes, the first histopathologic changes observed were scattered inflammatory infiltrates on day 15 and scattered foci of aspermatogenesis on day 20. Inflammatory lesions were first seen in the rete testis and the seminiferous tubules on day 25-30 with maximal involvement occurring on day 35-40. Early inflammatory lesions in the seminiferous tubules were characterized by peritubular and/or interstitial mixed cellular infiltrates. Later lesions included granuloma formation and necrosis. Autoimmune vasitis was not seen in any of the animals studied. Control rats immunized with rat liver homogenate plus adjuvants or adjuvants alone did not exhibit any of the histopathologic lesions described above. The observed results, when compared to those of previous studies examining the sequential histo- and immunopathology of active EAO in the guinea pig and mouse, support the concept that: 1) significant species specificity may exist with regard to regional differences in susceptibility to autoimmune attack within the male reproductive tract and 2) that such differences correlate with early maximal expression of Ia by cells within the male reproductive tract.
Experimental autoimmune orchitis (EAO) can be induced in vitro. Normal lymph node lymphocytes cultured with autologous dissociated testis cells form rosette-like aggregates and later undergo blast transformation and proliferation. These stimulated lymphocytes cause in vivo EAO lesions, when injectd into syngeneic recipients. Moreover, their autoimmune reactivity can be monitored by an in vitro cytostasis assay. Density gradient analysis of the early lymphocyte-testis cultures reveals that the autoimmune reactive lymphocytes are enriched in the rosette populations. It therefore appears that testicular self-antigens are recognized by clonally preformed autologous lymphocytes.
We report 3 patients with acute epididymo-orchitis with abscess formation due to Pseudomonas aeruginosa, which is relatively unusual and difficult to treat. All patients presented with swollen testicles, pain and high fever. First, they were treated empirically with several antibiotics. After several weeks of antibiotics therapy, the swelling of scrotum still persisted. In one patient, dark yellow pus drained from a fistula of the scrotum. Finally, an orchiectomy was performed on all patients. During the operation, an abscess was found in each testis. Each culture of the pus yielded P. aeruginosa, which is susceptible to many antibiotics.
Invasive infection and extraintestinal complications are rarely caused by Plesiomonas shigelloides, a waterborne bacterium implicated in gastroenteritis. Recent evidence from several reports suggests its importance in causing opportunistic infections in immunocompromised hosts. We report a case of P shigelloides bacteremia and epididymo-orchitis in a patient with HIV infection and chronic hepatitis C. This case illustrates a novel site of involvement by P shigelloides and underscores its role as an opportunistic pathogen.
Mumps orchitis is a dreaded complication of mumps is pubescent men. The literature on this subject includes epidemiological, clinical, histological and endocrine findings, indicating a marked variability of the clinical features from one patient to another, an alteration of endocrine function that can persist in the long term and finally post-mumps infertility, which is exceptional. On the other hand, relatively few studies have investigated the pathophysiological mechanisms, and suggest replication of the mumps virus in the testis. Based on these data from the literature, this article reviews or proposes various hypotheses concerning the various pathophysiological aspects of this disease and discusses the lines of research that could advance the current knowledge in order to improve the therapeutic management of patients, while also providing a better knowledge of the mumps virus and basic testicular physiology.
Structural changes and functional features of the testes were studied in 20 patients who had had parotid orchitis (PO) 6 months to 1.5 years before the study. The examination including ultrasonography of the testes, investigation of ejaculate, radioimmunoassay for serum testosterone, FSH, LH brought out a significant reduction of the mean volume and echogenicity of the affected testicles by 44.7 and 50%, respectively, in 15 patients; a 58.2% decrease in the number of spermatozoa in ml; a 71.2% rise in FSH level in 6 patients. Morphometry of biopsy specimen of the testicles on the affected side has shown that mean sectional area of the tubules has diminished by 40%, the spermatogenesis index--by 77.1% while the volume of the intertubular connective tissue increased by 47.7%. Thus, after acute PO, the patients develop atrophic changes in the testes and a decline in spermatogenic function up to secretory infertility.
Pseudoneoplastic Chlamydia trachomatis epididymo-orchitis is a rare clinical entity. The differential diagnosis with malignant tumour of the testis remains difficult and surgical exploration with orchidectomy is often difficult to avoid. Urgent testing for Chlamydia trachomatis by PCR in urine, semen and a urethral swab confirms the diagnosis and allows introduction of antibiotic therapy rather than surgical exploration.
Tuberculosis confined to the testes with no epididymal involvement is uncommon. Chronic renal failure patients requiring hemodialysis have increased risk for developing tuberculosis. We report a 47-year old chronic renal failure man presenting with right testicular tuberculous orchitis. A high index of suspicion is required to recognize the unusual presentation of tuberculosis in this group of patients, and routine screening for tuberculosis may be recommended in patients undergoing hemodialysis.
This case report try to point out the importance of early diagnosis, and an appropriate treatment in multifocal tuberculosis including a testicular localization. A 25 year-old male with a past history of tuberculosis contact and untreated chronic cough with haemoptysis is admitted in our in-patient clinic. Eighteen months earlier, he presented a long course fever, with lumbar pain. Thereafter, the patient condition worsened as he lost weight and developed an enlargement of the right testicle with an scrotal abscess fistulous and a meningo-encephalitis clinical presentation. The bacilloscopy performed on gastric specimen and scrotal caseous was negative. The cerebrospinal fluid was clear and showed a mixed formula with 370 cells including 50% of lymphocytes, an elevated albumin (0.70g/l) and low glucose (0.10g/l) . Sterile pus was detected in urine. The tuberculosis skin test was positive. In addition to the clinical and epidemiological context, the radiological findings (chest and spine X-ray, testicular ultrasonography, cerebral CT Scan) were consistent with multifocal tuberculosis infection with lung miliary, epididymal-orchitis, and brain tuberculomas. The patient was treated successfully using a two-step protocol: two-month treatment with isoniazid, rifampicin, ethambutol and pyrazinamid altogether; followed by a seven-month regimen with isoniazid and rifampicin. Nevertheless,the patient is likely to develop static trouble and infertility because of the spine sequela and testicle atrophy he presented.
Henoch-Schönlein purpura (HSP) is the most common cause of nonthrombocytopenic purpura in children. The clinical picture is classically a cutaneous purpuric eruption of the legs and buttocks and infrequently the upper torso and extremities. Arthritis, gastrointestinal tract symptoms, and nephritis are other common findings typically associated with the cutaneous findings. We present an unusual case of HSP with scrotal swelling and orchitis.
Testes of 8-week-old male Syrian hamsters which were inoculated intraperitoneally with 10(5) plaque-forming units of the D variant of encephalomyocarditis virus (EMC-D) were examined virologically and histologically. Viral replication was detected from 1 day post inoculation (1 DPI), became more prominent 3 DPI, and was no longer demonstrated 7 DPI. The weight of testis decreased in course of time and it was about 2% of that of control 6 weeks post inoculation (6 WPI). Histopathologically, degeneration and/or necrosis of germinal cells and spermatogonia were observed in many seminiferous tubules of all hamsters 3 DPI. At 7 DPI, luminal obstruction by cellular debris and subsequent replacement of them by mesenchymal cells were common in mildly atrophic tubules surrounded with inflammatory cells. Thereafter, atrophy of seminiferous tubules became severer with the lapse of time and, in addition to plasma cell infiltration, apparent increase in the number of Leydig cells was found in the interstices. No regenerative signs of germinal epithelia were detected by 6 WPI. This is the first report of EMC virus-induced orchitis.
A 66-year-old man came to us with a chief complaint of painful right scrotal swelling. The right testis was enlarged on the ultrasound gray scale, but the inside was homogeneous. A power Doppler ultrasound showed slightly increased vascular flow in the periphery of the right testis. As the soluble IL-2 receptor was 527 U/ml (normal: 220-530 U/ml), we considered malignant lymphoma and performed high orchiectomy. On pathological examination, the tumor was diagnosed as granulomatous orchitis. To our knowledge, this is the 21st case in Japan.
Granulomatous orchitis is a rare inflammatory disease of poorly understood etiology. Its differentiation from testicular tumor is difficult and is resistant to antibiotic therapy. Five cases of this disease are reported. In 3 of them orchiectomy was performed and in 2 the testis was preserved after biopsy specimen examination. Relapses or injury to the contralateral testis were not recorded during the follow-up period. A review of the literature is made and the etiopathogenesis, clinical and therapeutic aspects of this disease are discussed.
Laboratory experiments were followed by clinical investigations of low-intensity laser radiation (LR) feasibility in therapy of acute epididymo-orchitis. A total of 117 patients aged 15-68 were treated with mild, moderate and severe scrotal inflammation. The response was compared to that in physiotherapy (54 patients) and early surgery (40 patients). It proved higher by 38.5%, the proportion of the treatment failure diminished from 22.2% for conservative and 15% for surgical management to 7.7%. The duration of acute inflammation reduced to 3 days. There was a marked analgetic effect, arrest of intoxication, hyperthermia, autoimmune reactions. Scarring could be avoided. The discussion covers mechanisms of therapeutic action of laser therapy which is proposed for broad-scale application in any run of the inflammation. The test is suggested for the final choice of therapy to be made on day 2-3 of laser irradiation.
Five cases of granulomatous orchitis are reported and the literature is reviewed. The clinical features, pathology and treatment of this rare disease are discussed. In four cases the clinical features were chronic, while one patient had an acute course. The average age of the five patients was 31 years. In all cases we found only one testes was affected. In two cases the affected testis was removed, and in the remaining three cases only partial orchiectomy was performed.