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Urology Case Reports Sep 2019Amiodarone has a well-established and extensive side effect profile: pulmonary fibrosis, thyroid toxicity, corneal deposits, and skin discoloration. However, in some...
UNLABELLED
Amiodarone has a well-established and extensive side effect profile: pulmonary fibrosis, thyroid toxicity, corneal deposits, and skin discoloration. However, in some rare instances epididymitis/orchitis is a side effect of amiodarone. Symptoms range from testicular pain to swelling and erythema. The mechanism of how this toxicity occurs is unknown. In this case report, we will discuss the case of an elderly patient who developed epididymitis and orchitis after several years of tolerating amiodarone without any adverse events. Our patient underwent a full workup with testicular ultrasound, evaluation by the urology and cardiology services. His amiodarone was discontinued with complete resolution of symptoms.
DATA SOURCES
A community hospital in Stratford, NJ.
STUDY SELECTION
88 year old male patient with multiple comorbidities.
DATA EXTRACTION
Obtaining medical records on Soarian Cerner system.
DATA SYNTHESIS
Article analysis obtained from PubMed.
PubMed: 31198686
DOI: 10.1016/j.eucr.2019.100929 -
Seminars in Nuclear Medicine Nov 2023This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients... (Review)
Review
This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients presenting with an acute hemiscrotum for an early and reliable diagnosis of testicular torsion. The technique of testicular perfusion scintigraphy is described, and the characteristic findings are detailed with examples. The imaging characteristics of the various phases of testicular torsion and its differentiation from epididymitis and/or epididymo-orchitis and the other related conditions presenting as an acute hemiscrotum are detailed. In some cases, further evaluation by SPECT imaging increases the clarity and accuracy of diagnosis and, on occasion, hybrid SPECT/CT in selected complicated cases improves the diagnostic yield of the perfusion scintigraphy. Ultrasonographic and color Doppler findings are described concurrently with the scintigraphic findings. The several case examples presented demonstrate the additional clinical benefit of complementing functional and structural imaging for improving the sensitivity, specificity and accuracy of testicular imaging in the diagnosis.
Topics: Male; Humans; Spermatic Cord Torsion; Diagnosis, Differential; Orchitis; Epididymitis; Radionuclide Imaging
PubMed: 37210316
DOI: 10.1053/j.semnuclmed.2023.04.005 -
Urology Case Reports Sep 2019Intravesical immunotherapy with Bacillus Calmette-Guerin has been shown to decrease tumor recurrence and progression in urothelial carcinoma of the bladder. Its...
Intravesical immunotherapy with Bacillus Calmette-Guerin has been shown to decrease tumor recurrence and progression in urothelial carcinoma of the bladder. Its ubiquitous use is further substantiated by its low rates of complications. Our patient is a 63 year old male with a circuitous medical course who presents with epididymoorchitis and scrotal abscess after his second three week cycle of maintenance BCG prompting scrotal exploration which revealed a non-viable testicle and large scrotal induration with abscess. Pathological analysis and initial cultures were negative for mycobacterium but acid-fast cultures eventually demonstrated mycobacterium three months later.
PubMed: 31198685
DOI: 10.1016/j.eucr.2019.100925 -
Seminars in Cell & Developmental Biology Nov 2016The mammalian testis possesses a unique immune environment that is essential for testicular function. The testis is a remarkable immunoprivileged site that protects... (Review)
Review
The mammalian testis possesses a unique immune environment that is essential for testicular function. The testis is a remarkable immunoprivileged site that protects immunogenic germ cells from the detrimental effects of immune responses. However, the testis can be infected by various microbial pathogens. To overcome the immune privilege and enable testicular defense against microbes, the testis adopts local effective innate immune responses to microbial infections. The mechanisms underlying the testicular immune privilege have been investigated for several decades and the innate defense system in the testis is being revealed based on the identification of pattern recognition receptor-initiated innate immune responses in testicular cells. The coordination between immune privilege and local innate immune responses is critical in the maintenance of testicular immune homeostasis. Disruption of the testicular immune homeostasis may lead to orchitis and impair spermatogenesis, an etiological factor of male infertility. Dissection of the immunoregulatory mechanisms in the testis can aid in establishing preventive and therapeutic approaches for orchitis. This review discusses current understanding of the mechanisms which underlie the testicular immunoregulation and its effect on spermatogenesis.
Topics: Animals; Humans; Immunity, Innate; Leukocytes; Male; Models, Biological; Signal Transduction; Spermatogenesis; Testis
PubMed: 26805443
DOI: 10.1016/j.semcdb.2016.01.019 -
Journal of Biomedical Science Feb 2023Zika virus (ZIKV) infection is clinically known to induce testicular swelling, termed orchitis, and potentially impact male sterility, but the underlying mechanisms...
BACKGROUND
Zika virus (ZIKV) infection is clinically known to induce testicular swelling, termed orchitis, and potentially impact male sterility, but the underlying mechanisms remain unclear. Previous reports suggested that C-type lectins play important roles in mediating virus-induced inflammatory reactions and pathogenesis. We thus investigated whether C-type lectins modulate ZIKV-induced testicular damage.
METHODS
C-type lectin domain family 5 member A (CLEC5A) knockout mice were generated in a STAT1-deficient immunocompromised background (denoted clec5astat1) to enable testing of the role played by CLEC5A after ZIKV infection in a mosquito-to-mouse disease model. Following ZIKV infection, mice were subjected to an array of analyses to evaluate testicular damage, including ZIKV infectivity and neutrophil infiltration estimation via quantitative RT-PCR or histology and immunohistochemistry, inflammatory cytokine and testosterone detection, and spermatozoon counting. Furthermore, DNAX-activating proteins for 12 kDa (DAP12) knockout mice (dap12stat1) were generated and used to evaluate ZIKV infectivity, inflammation, and spermatozoa function in order to investigate the potential mechanisms engaged by CLEC5A.
RESULTS
Compared to experiments conducted in ZIKV-infected stat1 mice, infected clec5astat1 mice showed reductions in testicular ZIKV titer, local inflammation and apoptosis in testis and epididymis, neutrophil invasion, and sperm count and motility. CLEC5A, a myeloid pattern recognition receptor, therefore appears involved in the pathogenesis of ZIKV-induced orchitis and oligospermia. Furthermore, DAP12 expression was found to be decreased in the testis and epididymis tissues of clec5astat1 mice. As for CLEC5A deficient mice, ZIKV-infected DAP12-deficient mice also showed reductions in testicular ZIKV titer and local inflammation, as well as improved spermatozoa function, as compared to controls. CLEC5A-associated DAP12 signaling appears to in part regulate ZIKV-induced testicular damage.
CONCLUSIONS
Our analyses reveal a critical role for CLEC5A in ZIKV-induced proinflammatory responses, as CLEC5A enables leukocytes to infiltrate past the blood-testis barrier and induce testicular and epididymal tissue damage. CLEC5A is thus a potential therapeutic target for the prevention of injuries to male reproductive organs in ZIKV patients.
Topics: Humans; Male; Mice; Animals; Zika Virus; Zika Virus Infection; Orchitis; Semen; Mice, Knockout; Inflammation; Lectins, C-Type; Receptors, Cell Surface
PubMed: 36803804
DOI: 10.1186/s12929-023-00906-6 -
European Cytokine Network Sep 2018Many male infertility cases have no apparent cause, being characterized as idiopathic. Both inflammation and obesity have long been associated with infertility. On one... (Review)
Review
Many male infertility cases have no apparent cause, being characterized as idiopathic. Both inflammation and obesity have long been associated with infertility. On one hand, inflammation, such as orchitis and male accessory gland infections (MAGIs), are regulated by inflammatory cytokines. The latter are also produced in the testis by Leydig and Sertoli cells, being associated with gap junctional communication at the blood-testis barrier. Furthermore, they regulate spermatogenesis through cell interaction, Toll-like receptors and production of reactive oxygen species. Additionally, they affect testosterone production, acting at many levels of the pituitary - gonadal axis. Any imbalance in their production may result in infertility. On the other hand, obesity has also been associated with infertility. Adipokines, cytokines produced by white adipose tissue, regulate the lipid and glucose metabolism and the inflammatory system. Recent data on leptin show that it regulates reproduction by adjusting hypothalamus - pituitary - gonadal axis at both the central and peripheral levels. In this regard, resistin, visfatin and the GH secretagogue peptic hormone ghrelin affect spermatogenesis, whereas data on adiponectin are rather scarce. In conclusion, inflammatory cytokines and adipokines seem to have a pivotal role in the regulation of spermatogenesis; any imbalance in this stable environment may lead to infertility. Nevertheless, further studies are needed to clarify their exact role.
Topics: Animals; Cytokines; Humans; Hypothalamo-Hypophyseal System; Infertility, Male; Male; Orchitis; Reactive Oxygen Species; Sertoli Cells; Spermatogenesis
PubMed: 30547889
DOI: 10.1684/ecn.2018.0412 -
Annales de Dermatologie Et de... Nov 2016
Topics: Anti-Bacterial Agents; Chlamydia Infections; Epididymitis; Gonorrhea; Humans; Male; Orchitis
PubMed: 27773505
DOI: 10.1016/j.annder.2016.09.019 -
Urology Annals 2023Epididymo-orchitis (EO) is a common urological condition. In endemic areas, EO may be the presenting picture of brucellosis. Early suspicion and proper diagnosis is...
INTRODUCTION
Epididymo-orchitis (EO) is a common urological condition. In endemic areas, EO may be the presenting picture of brucellosis. Early suspicion and proper diagnosis is necessary for patient recovery.
OBJECTIVE
The aim of our study is to identify early predictors of EO.
PATIENTS AND METHODS
We retrospectively collected the data of all patients who were treated at the Urology Unit, Farwaniya Hospital, with acute EO above the age of 12 years between April 2017 and February 2019. Data from electronic and hardcopy files were gathered and analyzed. The diagnosis of acute EO was based on clinical, laboratory, and radiological findings. A total of 120 patients under the diagnosis of EO, epididymitis, and orchitis were reviewed. Thirty-one patients were tested for based on the history of animal contact, ingestion of unpasteurized dairy products, or persistent fever for more than 48 h. of those patients, 11 tested positive for orchitis.
RESULTS
A comparison between -positive and -negative patients regarding age, presence of fever, complete blood count (CBC) parameters, pyuria, and abscess formation was made. In the group, 72% of the patients had a history of animal contact compared to 33% in non- group ( = 0.006). When comparing CBC parameters in the two groups, group had statistically significant lower total leukocytic count and neutrophil count (mean ± standard deviation [SD]) 13.07 ± 4.22, 6.4 ± 9.98 versus negative group 17.35 ± 5.28, 7.8 ± 10.53, and values were 0.037 and 0.004, respectively. group showed lymphocytosis (mean ± SD) 25.95 ± 9.78 versus non- group 13.22 ± 8.05 and < 0.01.
CONCLUSION
orchitis constituted 9% of the orchitis patients treated in our hospital. Patients with a history of animal contact, EO with lymphocytosis, and relative neutropenia should raise the suspicion for orchitis in endemic areas.
PubMed: 37304522
DOI: 10.4103/ua.ua_178_21 -
Urologie (Heidelberg, Germany) Jun 2024Acute genital diseases can occur at any age and are characterized by complaints of various kinds of the external genitalia. Pain, swelling, and redness of the scrotum,...
Acute genital diseases can occur at any age and are characterized by complaints of various kinds of the external genitalia. Pain, swelling, and redness of the scrotum, adjacent groin region, and immediate surroundings are the leading symptoms, the severity of which may vary. In addition, peritonitic symptoms such as nausea, vomiting, and circulatory sensations may be present and are comparable to symptoms of an acute abdomen. The term "acute scrotum" encompasses various clinical entities, where scrotal symptoms are predominant and represent a urological emergency situation. Immediate and comprehensive diagnostics are necessary to ensure timely management in case of necessary surgical intervention.
Topics: Humans; Male; Acute Disease; Diagnosis, Differential; Genital Diseases, Male; Scrotum
PubMed: 38689028
DOI: 10.1007/s00120-024-02335-1 -
Andrologia Apr 2022
Topics: COVID-19; COVID-19 Vaccines; Epididymitis; Humans; Male; Orchitis; SARS-CoV-2; Vaccination
PubMed: 34866218
DOI: 10.1111/and.14340