Orquiepididimitis por Salmonella spp en un lactante bajo los tres meses de edad

El compromiso genitourinario en una infección causada por Salmonella spp es poco frecuente, especialmente en niños. Se presenta un paciente de 40 días de vida que presentó una orquiepididimitis por Salmonella entérica serotipo Newport, con documentación microbiológica en hemocultivos, cultivo de secreción escrotal y coprocultivo. No presentó compromiso del sistema nervioso central. Un tratamiento médico y quirúrgico tempranos permitieron la evolución favorable del paciente.

Genitourinary involvement in a Salmonella spp infection is rare, especially in pediatric patients. A 40-day-old patient who presented an orchiepididymitis due to Salmonella enterica Serotype Newport is reported, with microbiological documentation in blood cultures, culture of scrotal purulent material and stool culture. There was no involvement of the central nervous system. Early medical and surgical treatment allowed the favorable evolution of the patient.

Testicular exosomes disturb the immunosuppressive phenotype of testicular macrophages mediated by miR-155-5p in uropathogenic Escherichia coli-induced orchitis / 亚洲男科学杂志(英文版)

Male reproductive infections are known to shape the immunological homeostasis of the testes, leading to male infertility. However, the specific pathogenesis of these changes remains poorly understood. Exosomes released in the inflammatory microenvironment are important in communication between the local microenvironment and recipient cells. Here, we aim to identify the immunomodulatory properties of inflammatory testes-derived exosomes (IT-exos) and explore their underlying mechanisms in orchitis. IT-exos were isolated using a uropathogenic Escherichia coli (UPEC)-induced orchitis model and confirmed that IT-exos promoted proinflammatory M1 activation with increasing expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in vitro. We further used small RNA sequencing to identify the differential miRNA profiles in exosomes and primary testicular macrophages (TMs) from normal and UPEC-infected testes, respectively, and identified that miR-155-5p was highly enriched in IT-exos and TMs from inflammatory testes. Further study of bone marrow derived macrophages (BMDMs) transfected with miR-155-5p mimic showed that macrophages polarized to proinflammatory phenotype. In addition, the mice that were administrated IT-exos showed remarkable activation of TM1-like macrophages; however, IT-exos with silencing miR-155-5p showed a decrease in proinflammatory responses. Overall, we demonstrate that miR-155-5p delivered by IT-exos plays an important role in the activation of TM1 in UPEC-induced orchitis. Our study provides a new perspective on the immunological mechanisms underlying inflammation-related male infertility.

Overview of human and animal brucellosis in Nigeria and its economic impacts on production

Brucellosis is a wide spread zoonotic bacterial disease of humans and animals. In humans the disease is recognized commonly as undulant fever, characterized by headache malaise, and arthritis. Brucellosis can occur in any age group, but mainly found in young men between the ages of 20 and 40 years because of occupational hazards. Domestic animals (cattle, sheep and goat, pigs, dogs etc) are highly susceptible to brucellosis. Generally, brucellosis manifest in female animals as abortion, retained placenta, stillbirth and death of young ones soon after birth. In males, the main features are vesiculitis, orchitis, and epididymitis, which may render infected male infertile for life. The endemicity of brucellosis has remained a threat in low- income countries of sub-Saharan Africa and South Asia and has multiple economic implications across agriculture and public health sectors, and broader implications on economic and social development sectors. Google and Google Scholar were used to retrieve articles used for this review, which included published research articles and local, national and international reports on brucellosis. In this review, we summarised human and animal brucellosis, prevalence of infections in Nigeria, and economic impacts on production. It is believed that this review will guide researchers on the state of brucellosis in developing countries where the disease is still endemic, using Nigeria as a case study.

Clinical characteristics of Brucella epididym-orchitis / 中华地方病学杂志

Objective:To understand the clinical characteristics of Brucella epididym-orchitis (BEO). Methods:The clinical data of married male patients with brucellosis in acute stage admitted to Hulunbuir People's Hospital from September 2017 to October 2019 were collected and divided into BEO group and non-BEO group, with 46 and 50 cases, respectively. The clinical manifestations, laboratory examination and treatment effect were analyzed and evaluated.Results:The frequency of lower abdominal pain, erectile dysfunction and premature ejaculation in BEO group were higher than those in non-BEO group [26.1% (12/46) vs 8.0% (4/50), 89.1% (41/46) vs 12.0% (6/50), and 28.3% (13/46) vs 6.0% (3/50), χ 2 = 5.643, 57.037, 8.548, P < 0.05]. In laboratory examination, the incidence of increased leukocyte (WBC) count in BEO group was significantly higher than that in non-BEO group [23.9% (11/46) vs 8.0% (4/50), χ 2 = 4.602, P < 0.05]. In terms of sperm function, the incidence of decreased sperm dens (DENS) in BEO group was significantly higher than that in non-BEO group [21.7% (10/46) vs 2.0% (1/50), χ 2 = 9.201, P < 0.05]. After 2 - 7 d of treatment, the pain and/or tenderness of scrotum were relieved in all patients with BEO. After 3 - 5 d of treatment, the symptoms of BEO patients with lower abdominal pain and dysuria were relieved. After 12 weeks of treatment, 97.8% (45/46) of BEO patients had normal scrotal and testicular ultrasonography; 95.1% (39/41) of BEO patients had normal erectile function, 76.9% (10/13) of BEO patients had no premature ejaculation, and DENS returned to normal in 80.0% (8/10) of patients with DENS decreased. Five cases' sperm motility (PRNPPER) returned to normal of 6 patients with PRNPPER decreased. Conclusion:BEO patients have the clinical characteristics of lower abdominal pain, erectile dysfunction, premature ejaculation and spermatogenic dysfunction, and the overall prognosis is good after treatment.

Rare presentations of acute appendicitis

Acute appendicitis is the one of the most common emergency conditions that the rural surgeon must deal with. Though the majority of patients present with the typical symptoms of right iliac fossa pain, nausea and anorexia, many patients do present with atypical symptoms and signs. These patients present a challenge to rural surgeons. Acute appendicitis is a great mimic and can present with a variety of symptoms. The eyes don’t see what the mind doesn’t know and it is important to know the various ways in which appendicitis can present and to always keep it as a differential diagnosis while managing a patient with acute abdomen. In this paper we have looked at 4 different presentations of appendicitis. Appendicitis is a great mimic and should always be kept as a differential for acute abdomen.

Effect of ketotifen fumarate on experimental autoimmune orchitis and torsion of the spermatic cord / 亚洲男科学杂志(英文版)

The aim of this work was to study effects of ketotifen fumarate (KF) on prevention of tissue damage in testes of rats with experimental autoimmune orchitis (EAO) and on the contralateral testis in a model of prolonged testicular cord torsion (TCT). Rats with EAO or TCT were injected intraperitoneally once daily with KF or saline solution (vehicle group). Incidence and severity of testicular damage were evaluated by histopathology using an EAO score or a Johnsen score. Mast cells (MC) were identified by histochemistry and quantified. In EAO model, KF significantly reduced severity of histopathological testicular damage compared to rats in the vehicle group. KF also reduced the number of testicular MC compared to vehicle group. Similarly, in TCT model, multifocal damage of the contralateral testis was observed 30 days after testicular torsion characterized by sloughing of the germinal epithelium, seminiferous tubule atrophy, and interstitial edema. Focal signs of inflammation and fibrosis of seminiferous tubular walls were also observed. In contrast, sections of contralateral testis of rats injected with KF and killed 30 days after surgery showed normal histological features. A significant decrease in the number of MC was observed in rats treated with KF compared to untreated animals. In conclusion, we demonstrated that treatment with KF reduced testicular inflammatory process and MC infiltrates in both EAO and TCT models. The results suggest a promising treatment for infertile male patients with testicular pathologies associated with inflammation and germ cell loss.

Effect of ketotifen fumarate on experimental autoimmune orchitis and torsion of the spermatic cord / 亚洲男科学杂志(英文版)

The aim of this work was to study effects of ketotifen fumarate (KF) on prevention of tissue damage in testes of rats with experimental autoimmune orchitis (EAO) and on the contralateral testis in a model of prolonged testicular cord torsion (TCT). Rats with EAO or TCT were injected intraperitoneally once daily with KF or saline solution (vehicle group). Incidence and severity of testicular damage were evaluated by histopathology using an EAO score or a Johnsen score. Mast cells (MC) were identified by histochemistry and quantified. In EAO model, KF significantly reduced severity of histopathological testicular damage compared to rats in the vehicle group. KF also reduced the number of testicular MC compared to vehicle group. Similarly, in TCT model, multifocal damage of the contralateral testis was observed 30 days after testicular torsion characterized by sloughing of the germinal epithelium, seminiferous tubule atrophy, and interstitial edema. Focal signs of inflammation and fibrosis of seminiferous tubular walls were also observed. In contrast, sections of contralateral testis of rats injected with KF and killed 30 days after surgery showed normal histological features. A significant decrease in the number of MC was observed in rats treated with KF compared to untreated animals. In conclusion, we demonstrated that treatment with KF reduced testicular inflammatory process and MC infiltrates in both EAO and TCT models. The results suggest a promising treatment for infertile male patients with testicular pathologies associated with inflammation and germ cell loss.

Clinical Study on Acute Inflammatory Inguinoscrotal Lesions

Introduction: Acute inguinoscrotal swellings are the most common swellings affecting both children and adults.Although these swellings are frequently encountered, many times correct diagnosis is not made and testes have beensacrificed. A wide variety of acute inflammatory conditions affects inguinoscrotal region and testes such as inguinalabscess, funiculitis, inguinal lymphadenitis, primary infections of scrotum, and/or secondary infection of testes such asepididymo-orchitis and scrotal abscess, pyocele, and Fournier’s gangrene. Knowledge of the risk factors, prevention,and early detection with prompt treatment of inguinoscrotal lesions, which leads to reduction in morbidity and mortalityassociated with these lesions.Materials and Methods: In this prospective study carried out in 195 patients in the Department of Surgery, Shyam ShahMedical College and associated Gandhi Memorial and Sanjay Gandhi Memorial Hospitals, Rewa, Madhya Pradesh, during theperiod of 1 June 2017 to 31 May 2018. All male patients with complaints of acute painful inguinoscrotal swelling and ulcer witha history of <2 weeks were included in the study. Presenting complaints and detailed history were recorded in a predesignedpro forma. Thorough general examination and local examination were done. Patients were investigated and final diagnosiswas established. Then, treatment was initiated according to diagnosis.Results: Acute epididymo-orchitis (42.6%) was the most common cause for acute inguinoscrotal pathology followed byFournier’s gangrene (19.5%) and scrotal abscess (17.9%). Majority patients belong to the age group of 31–40 years, 22.6%and in the age group of 41–50 years, 20.5%. The most common predisposing factor was lower urinary tract syndrome presentin 47.1% followed by poor personal hygiene (43.07%). Conservative treatment was given in 80 patients. All, except eight casesof epididymo-orchitis (83), two cases of scrotal cellulitis and four cases of inguinal lymphadenitis were treated conservatively.All 38 cases of Fournier’s gangrene and one case of scrotal cellulitis were treated by debridement and daily dressings. Incisionand drainage of pyocele was carried out in five patients. Scrotal exploration with drainage of testicular abscess was done inthree cases. Orchidectomy was required in two cases of testicular abscess.Conclusion: Acute inguinoscrotal lesions are common in younger and middle age individuals with variable symptomatology.Such conditions presenting to emergency department need careful examination, proper evaluation, and prompt treatment.Conservative treatment with rest, scrotal support, antibiotics, and analgesics is effective in case of epididymo-orchitis.Emergency surgical exploration proved to be the best in case of scrotal abscess, Fournier’s gangrene, pyocele, andhematocele. Various predisposing factors can be minimized by proper health education and developing good primary healthcare system.

Clinicopathological study of testicular lesions

Background: Testis is affected by both neoplastic and non neoplastic conditions. Non neoplastic lesions of the testis include epididymo-orchitis, testicular atrophy, undescended testis, testicular abscess etc. Testicular tumors are relatively rare. They constitute the 4th most common cause of death from neoplasia in the young males. This study was undertaken to study the histopathological spectrum, age wise distribution and clinical symptoms of testicular lesions.Methods: This is a retrospective study of three years conducted in the department of pathology, Aurangabad from June 2015 to May 2018. It included all the orchidectomy specimens received from the department of surgery and excluded the orchidectomy specimens sent for infertility and prostatic carcinoma. A detail clinical history was taken. Histopathological examination was done after routine processing and staining with H and E. The data collected was tabulated, analysed and compared to other similar studies.Results: We studied 70 cases. Non neoplastic testicular lesions were 57 and 13 were neoplastic. Non neoplastic testicular lesions were more common than the neoplastic ones. Non neoplastic testicular lesions presented most commonly in the 2nd decade. Most common non neoplastic lesion was epididymo-orchitis followed by torsion, atrophy and testicular abscess. Most common neoplasm was malignant mixed germ cell tumor. Most of the patients of neoplasms presented in the 3rd decade. The most common complaint was testicular swelling and pain.Conclusions: Majority of testicular lesions are non neoplastic. Neoplastic lesions are rare. Non neoplastic lesions mimic neoplastic ones clinically, as testicular swelling is the most common complaint. So histopathological diagnosis is necessary for an accurate diagnosis of testicular lesions.

Orchitis: An unusual presentation of polyarteritis nodosa

Polyarteritis nodosa (PAN), a systemic necrotizing vasculitis with multiorgan development, is generally restricted to the medium-sized muscular arteries. The varied initial clinical presentations of PAN can lead to a delayed diagnosis. We present the case of a middle-aged male patient who presented with an acute onset right-sided testicular pain as the initial clinical symptom with ischemic changes on ultrasonogram, thereby requiring orchiectomy. This was reported to be a case of tubercular epididymo-orchitis. On review, the biopsy revealed features of necrotizing arteritis as seen in PAN with fibrinoid necrosis and giant cells, thus highlighting the fact that vasculitis due to PAN may have a localized presentation at the time of diagnosis. PAN should be distinguished from other causes of epididymo-orchitis and other vasculitis lesions, the most common being tubercular etiology in the Asian population.

Ultrasound evaluation of inguinoscrotal pain: an imaging-based review for the ultrasonographer / Avaliação ultrassonográfica da dor inguinoescrotal: uma revisão baseada em imagens para o ultrassonografista

Abstract Emergencies involving the inguinal region and scrotum are common and can be caused by a plethora of different causes. In most cases, such conditions have nonspecific symptoms and are quite painful. Some inguinoscrotal conditions have high complication rates. Early and accurate diagnosis is therefore imperative. Ultrasound is the method of choice for the initial evaluation of this vast range of conditions, because it is a rapid, ionizing radiation-free, low-cost method. Despite the practicality and accuracy of the method, which make it ideal for use in emergency care, the examiner should be experienced and should be familiarized with the ultrasound findings of the most common inguinoscrotal diseases. On the basis of that knowledge, the examiner should also be able to make an accurate, direct, precise report, helping the emergency room physician make decisions regarding the proper (clinical or surgical) management of each case. Here, we review most of the inguinoscrotal conditions, focusing on the imaging findings and discussing the critical points for the appropriate characterization of each condition.

Resumo As emergências envolvendo a região inguinal e o escroto são frequentes, derivadas de diferentes causas, e na maioria das vezes apresentam-se clinicamente de modo não específico e bastante dolorosas. Algumas destas condições apresentam elevado potencial de gravidade, sendo imperioso um diagnóstico rápido e preciso. A ultrassonografia é, indiscutivelmente, o método de escolha na avaliação inicial de todo o vasto leque de doenças nessas regiões, sendo rápido, de baixo custo e sem uso de radiação. Além da praticidade e acurácia do método, ideal para a prática em âmbito de pronto-atendimento, a experiência do examinador, o qual deve estar familiarizado com os principais achados de imagem, é fundamental para a precisão diagnóstica. Some-se a isto a necessidade de um relatório claro e assertivo, auxiliando o médico emergencista na terapêutica apropriada a cada caso, seja clínica ou cirúrgica. Procuramos trazer uma revisão baseada nos achados de imagem das principais afecções dolorosas inguinais e escrotais, discutindo os pontos-chaves para sua adequada caracterização.

A study on causes and management of acute scrotal conditions

Acute scrotal conditions form a significant proportion of cases in surgical ward. They contribute to significant morbidity in younger age group and mortality in older age group. In this study we have attempted to study the causes, aetiology, prevalence and management of acute scrotal conditions. The prevalence in descending order was Acute epididymo orchitis, Pyocele, Hematocele, Fournier’s gangrene, Acute filarial scrotum, Testicular torsion, Scrotal abscess, Mumps orchitis, scrotal trauma. Of these Epididymo orchitis, mumps orchitis and Filarial scrotum were treated conservatively with antibiotics, rest and scrotal support. Fournier’s gangrene, Scrotal abscess and scrotal trauma with wound debridement and reconstruction. Pyocele and hematocele by incision and evacuation of pus and blood respectively. Testicular torsion is treated by surgical de rotation and B/L orchidopexy. Orchidectomy was done if warranted in hematocele, pyocele, and testicular torsion.

Incremental Role of ¹⁸FDG PET/CT in Assessment of Testicular Viability / 대한핵의학회잡지

Testicular torsion is a common differential diagnosis of acute scrotal pain along with acute epididymo-orchitis, which may lead to testicular non-viability. Doppler ultrasound and testicular scintigraphy are two routinely used modalities for the assessment of testicular viability. However, in some cases, these investigations may prove inadequate in differentiating between the two entities with widely differing management. Here, we present a case of a 52-year-old male with questionable viability of testis, who was investigated initially using testicular scintigraphy and was further subjected to a regional 18F-FDG PET/CT scan, in view of inconclusive findings with the conventional modalities.

Epididymo-orchitis caused by Histoplasma capsulatumin a Colombian patient

Abstract Although histoplasmosis is generally a self-limited disease, disseminated infection can occur in patients lacking effective cell-mediated immunity, reaching virtually every organ, even the genitourinary tract in rare cases. We report a case of epididymo-orchitis in an immunocompetent 38-year-old bricklayer from the rural area of Villeta, Cundinamarca, Colombia. The patient presented with testicular pain and macroscopic scrotal changes requiring a left orchiectomy, with microbiological isolation and molecular confirmation of Histoplasma capsulatum.

Medical Cases that PENG Jianming Uses Goujutang in Curing Epididymitis and Orchitis / 浙江中医药大学学报

[Objective]The article summarizes the essentials of clinical dialectical experience by PENG Jianming on using Goujutang in curing epididymits and orchitis.[Methods]From following teacher PENG's clinical studies, recording teacher PENG's three medical cases and making analysis,we can summarize the thoughts and experience on using Goujutang in treating epididymits and orchitis.[Results]Teacher Peng considers that epididymits and orchitis have disease much due to the liver channel downward flow of damp-heat, causing local blood stagnation, so treatment Goujutang as basic party to smooth liver regulating qi,resolve dampness and clear away heat;and then plus the herbal medicine which can clear away heat and toxic materials,clearing damp and promoting diuresis,softening hardness to dissipate stagnation,removing stasis to ease pain.So we use Goujutang to treat epididymitis and orchitis, which can obtain good effect.[Conclusion]Teacher PENG's experience on using Goujutang in treating epididymits and orchitis has positive effect and is worthy of further study.

The clinical characteristics of patients with Brucellar epididymo-orchitis / 中华地方病学杂志

Objective To present the distinction on clinical features,laboratory features,treatment schemes between the patients with and without brucellar epididymo-orchitis,and to provide a theoretical basis for clinical diagnosis and treatment.Methods A retrospective analysis of 223 male patients with brucellosis in the First Hospital of Jilin University from June 2010 to November 2016 was carried out.A comparative analysis of the clinical and laboratory features of 22 patients with epididymo-orchitis and 201 cases without epididymo-orchitis was done.The SPSS 23.0 software was used to analyze the statistical results,P ＜ 0.05 was defined as statistically significant.Results Epididymo-orchitis occurred in 9.87％ (22/223) of all male patients with brucellosis.The median ages of patients with and without epididymo-orchitis were 35.5 and 42.0 years old,respectively,the difference was not statistically significant (Z =1.323,P ＞ 0.05).Cases with and without epididymo-orchitis of brucellosis with fever [90.9％ (20/22) vs 69.2％ (139/201)],chills [54.4％ (12/22) vs 28.9％ (58/201)],hepatomegaly [22.7％ (5/22) vs 3.5％ (7/201)],abdominal symptoms [59.1％ (13/22) vs 17.4％ (35/201)],and urinary tract infection symptoms [31.8％ (7/22) vs 3.5％ (7/201)],the differences were statistically significant (x2 =4.586,6.076,14.424,20.392,27.059,all P ＜ 0.05).The medians of white blood cell (WBC) count (7.9 × 109/L),erythrocyte sedimentation value (ESR,38.0 mm/h),and aspartate aminotransferase (AST,110.0 U/L) in brucellosis with epididymo-orchitis were higher than those without epididymo-orchitis (5.1 × 109/L, 30.0 mm/h,73.8 U/L),the differences were statistically significant (Z =2.239,2.064,2.762,all P ＜ 0.05).All brucellosis patients with epididymis-orchitis were treated with antibiotics for 8 weeks.The defervescence time was 4.5 days,the time of pain relief was 3.9 days,21 patients were cured,and only Ⅰ patient relapsed.Conclusions Epididymo-orchitis is a common complication of brucellosis.Brucellar epididymo-orchitis is usually characterized with a severe acute clinical presentation,which needs timely diagnosis.Combination of antibiotics treatment for 8 weeks in brucellosis patients with epididymis-orchitis is effective.

First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

ABSTRACT Although tuberculosis (TB) is a curable disease, it continues to be one of the leading infections associated with death in the world. Extra-pulmonary TB (EPTB) occurs in approximately 10% of the total cases, presenting with lymph nodes, pleura, bone and genitourinary tract as the most common locations. Genitourinary tuberculosis, the second most common EPTB, is very difficult to diagnose unless there is a high index of suspicion. Isolated TB orchitis or prostatitis without clinical evidence of renal involvement is a rare entity among genitourinary tuberculosis. We presented the first reported case of TB prostatitis and orchitis associated with pulmonary TB and the presence of an acute massive caseous pneumonia in an immunocompetent man. Despite the anti-TB therapy, the patient presented a rapid progression of disease and deterioration of general conditions taking to death, which occurred four days after TB treatment had started. Disseminated TB is a relatively uncommon cause of acute massive caseous pneumonia; however, there should always be suspicion of the disease, since it is a potentially treatable cause. This rare case supports the assertion that TB should be considered as an important differential diagnosis of genitourinary tumors irrespective of evidence of active TB elsewhere in the body.

Trend of human brucellosis over a decade at tertiary care centre in North Karnataka.

Background: Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. Materials and Methods: The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka. A total of 3610 serum samples were evaluated from suspected cases of brucellosis. All serum samples were initially screened by Rose Bengal plate test, and positive samples were further analysed by Serum agglutination test (SAT) using standard Brucella abortus antigen from Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India. A titre above or equal to 1:80 IU/ml was considered as positive. Demographic data such as age, sex and native place of these patients were also analysed. Results: We observed that human brucellosis is present in North Karnataka. The overall seropositivity of brucellosis in suspected cases was 5.1%. The positive titres ranged from 1:80 to 163,840 IU/ml. The majority of the patients were from Gadag, Koppal and Haveri districts of North Karnataka. Conclusion: Our study confirms the presence of human brucellosis in the northern part of Karnataka. Further studies to understand the prevalence of animal brucellosis in these areas will help in implementing prevention measures.

Clinical analysis of 23 patients with Brucellar epididymo-orchitis / 中华地方病学杂志

Objective Study the epidemiological and clinical findings of patients with Brucellar epididymo-orchitis (BEO),to provide a theoretical basis for clinical diagnosis.Methods A study was carried out to analyze the patients' files of epidemiological,outcome,clinical and laboratory features of 23 cases of BEO and 185 in patients with brucellosis in Hulunbuir People's Hospital during 2011-2013.Results The age of patients with BEO and without epididymo-orchitis (EO) were (34.48 ± 10.32) years old and (42.07 ± 12.19) years old,the difference was statistically significant (t =-2.842,P ＜ 0.05).Patients with BEO and without EO of brucellosis patients with hypogastralgia ratio was 78.3％ (18/23) and 8.6％ (14/162),the difference was statistically significant (x2 =68.238,P ＜ 0.05).The proportion of BEO cases with abnormal White Blood of Cell (WBC) and C-reactive protein (CRP) levels were 34.8％ (8/23) and 91.3％ (21/23),which was significantly higher than those in without EO group [9.9％ (16/162),63.0％ (102/162),x2 =11.066,7.260,all P ＜ 0.05].After 2 to 7 days,BEO patients with scrotal swelling and pain and/or tenderness relieved.After two weeks treatment,11 patients of the urinary system showed normal by ultrasound,and no patients underwent testicular resection.Conclusions Young male patients with Brucellar are prone to BEO.Laboratory abnormalities are mainly leukocytosis and high CRP level.

Blood testosterone levels of patients with mumps orchitis / 中国基层医药

Objective To analyze the effects of the mumps virus on testicular function and evaluate the value of blood testosterone in acute orchitis condition and prognosis by observing the testosterone levels of peripheral blood in the mumps orchitis patients.Methods Thirty patients with acute mumps orchitis (mumps orchitis group)and 28 patients with mumps only without any major complications (mumps group)were enrolled in the study.At the same time,we selected 20 healthy males in our hospital as healthy controls.All cases were treated by ribavirin (10mg/kg). The testosterone was tested by chemiluminescence method,in 0,7,14 days respectively.The variance analysis and LSD -t test were used to compare differences of blood testosterone in each group,and Pearson method was used to analyze the correlation of blood testosterone and testicular swelling day times,blood amylase,level of neutrophils,IL -6 and CRP.Results The testosterone of acute orchitis [(1.51 ±0.26)ng/mL]was lower than mumps group and healthy controls.The difference was significant(F =99.36,P <0.01).The level of blood testosterone was significantly increased in the treatment for 14 days (t =13.03,P <0.01),and there was no significant difference compared with healthy controls (t =1.23,P =1.23).Pearson correlation analysis found that blood testosterone levels were negatively correlated with the days of testicular swelling,the levels of IL -6 and CRP(r =0.678,P <0.01 and r =0.528,P =0.000;r =0.442,P =0.000).Conclusion This study showed that MuV infection inhibited testosterone synthesis in Leydig cells.In other words,the level of blood testosterone is related to the severity of the orchitis,which can be widely used in clinical.