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Infectious Diseases & Clinical... Dec 2023Brucellosis is one of the most prevalent zoonoses worldwide and is endemic in Türkiye. It is a multisystemic infection that can affect various organ systems....
OBJECTIVE
Brucellosis is one of the most prevalent zoonoses worldwide and is endemic in Türkiye. It is a multisystemic infection that can affect various organ systems. Epididymo-orchitis is the most common form of genitourinary involvement. This study aimed to evaluate the incidence, clinical characteristics, laboratory values, and treatment outcomes of brucellar epididymo-orchitis (BEO) in the East Anatolian region, where brucellosis is hyperendemic.
MATERIALS AND METHODS
This study was conducted between January 1, 2018, and April 30, 2019. All male patients diagnosed with brucellosis at the infectious disease clinic were evaluated for epididymo-orchitis according to clinical findings (testicular pain, swelling, erythema). In addition, to identify BEO patients, all epididymo-orchitis cases admitted to the urology outpatient clinic according to the study protocol were referred to the infectious diseases clinic for infection. Patients were enrolled prospectively, and data were analyzed retrospectively.
RESULTS
infection was diagnosed in 326 patients during the study period, of whom 208 (63.8%) were male. Brucellar epididymo-orchitis was diagnosed in 18 patients at the end of sixteen months. The incidence of epididymo-orchitis in patients with infection was 8.7%. The mean age of the patients was 36.9±11.5 years. The majority of patients had occupational animal contact (83.3%) and consumption of fresh cheese made from raw milk (55.5%). Acute brucellosis was diagnosed in 17 (94.4%) patients; all patients presented with scrotal pain and swelling. Unilateral epididymo-orchitis was observed in 16 (88.8%) patients. Most patients (88.3%) applied to outpatient clinics other than infectious diseases, especially the urology clinic (77.7%).Double or triple combined treatments with aminoglycoside/doxycycline/rifampicin were given to the patients. Hydrocelectomy was performed in three patients, orchiectomy in one patient, and relapse was seen in one patient.
CONCLUSION
infection should be considered in patients presenting with epididymo-orchitis in endemic regions. Awareness of brucellosis by urologists will ensure that the disease is diagnosed without complications.
PubMed: 38633857
DOI: 10.36519/idcm.2023.253 -
SAGE Open Medical Case Reports 2024Amyand's hernia is a rare condition characterized by an inguinal hernia containing the appendix, which can lead to complications. It is more common in children and it...
Amyand's hernia is a rare condition characterized by an inguinal hernia containing the appendix, which can lead to complications. It is more common in children and it can be challenging to diagnose due to its location, often being mistaken for other conditions like strangulated hernias, orchitis-epididymitis, or testicular torsion. Imaging, including computed tomography and sonography, plays an important role in diagnosis, which is usually made intraoperatively. A case concerning a 3-month-old boy with a large acute scrotum that had been evolving for 4 days was presented. Clinical examination revealed a hard inguinal mass and a large scrotum with signs of inflammation. An inguinoscrotal ultrasound found a herniated appendix, suggesting the diagnosis of Amyand's hernia, which was confirmed after surgery.
PubMed: 38606031
DOI: 10.1177/2050313X241246876 -
The Oncologist Jun 2024In male patients with cancer treated with antineoplastic drug, hypogonadism is a neglected cause of diminished quality of life. This condition may be cancer related as...
BACKGROUND
In male patients with cancer treated with antineoplastic drug, hypogonadism is a neglected cause of diminished quality of life. This condition may be cancer related as well as toxicity related. The role of antineoplastic drug in causing hypogonadism is poorly understood. The aim of this systematic review was to establish the prevalence, nature (primary/secondary), and impact of hypogonadism on quality of life in male patients with cancer on antineoplastic therapy.
METHODS
The search strategy used PubMed, Embase, and Cochrane databases to select articles in English language that described hypogonadism in male patients with cancer. The search period was from January 1, 1945 to February 28, 2023. We included observational studies, case reports or case series and excluded studies concerning hematological malignancies, prostate cancer, female patients, and survivors.
FINDINGS
Of 4488 records identified, 28 studies met inclusion criteria (17 observational studies, 11 case reports or case series). Anti-angiogenic drugs and crizotinib were found to have a role in the development of hypogonadism. Patients treated with immune checkpoint-inhibitors developed secondary hypogonadism due to immune-related hypophysitis or orchitis. As for active chemotherapy, platinum salts were often associated with hypogonadism, followed by antimetabolites and taxanes. Selected studies were heterogeneous for populations, interventions, and outcomes assessments. Thus, a generalization is difficult. Moreover, the role of concurrent etiologies cannot be excluded in most studies.
CONCLUSION
Our research emphasizes the importance of evaluating the gonadal axis before treatment in patients considered at risk and testing it at regular intervals or in case of clinical suspicion.
Topics: Humans; Male; Hypogonadism; Neoplasms; Antineoplastic Agents; Quality of Life
PubMed: 38518107
DOI: 10.1093/oncolo/oyae024 -
Urology Case Reports May 2024Urothelial carcinoma of the bladder remains a challenging disease to treat. Intravesical instillation of BCG has demonstrated tremendous efficacy in preventing...
Urothelial carcinoma of the bladder remains a challenging disease to treat. Intravesical instillation of BCG has demonstrated tremendous efficacy in preventing recurrence. BCG related necrotizing granulomatous epididymo-orchitis is rare and has not been previously linked to brachytherapy for adenocarcinoma of the prostate. We hypothesize that prior brachytherapy has a deleterious effect on the verumontanum that can result in retrograde transmission of BCG particles leading to granulomatous epididymo-orchitis. This is the first case report of necrotizing granulomatous epididymo-orchitis related to BCG in a patient status post brachytherapy for adenocarcinoma of the prostate.
PubMed: 38516176
DOI: 10.1016/j.eucr.2024.102694 -
Urology Case Reports May 2024We report a case of epididymo-orchitis (EO) in a 12-day-old Saudi boy. The neonate, initially diagnosed with hydrocele post-delivery, presented with left scrotal...
We report a case of epididymo-orchitis (EO) in a 12-day-old Saudi boy. The neonate, initially diagnosed with hydrocele post-delivery, presented with left scrotal swelling. Doppler ultrasound revealed normal testicles but an enlarged, echogenic left epididymis with pyocele. Despite initial therapy with amoxicillin and cefotaxime, a repeated ultrasound indicated compromised testicular vascularity, necessitating emergency surgical exploration. This revealed purulent discharge and inflammation, with as a causative agent. Post-surgery, the patient showed significant improvement and was discharged in good condition after a ten-day of hospitalization. The study emphasizes the significance of including EO in the possible diagnoses for neonatal scrotal swelling.
PubMed: 38516173
DOI: 10.1016/j.eucr.2024.102702 -
The World Journal of Men's Health Mar 2024Recent studies on male infertility reveal a growing worry: more infertile men are dealing with inflammation in the testis. Analyzing testicular biopsies from infertile... (Review)
Review
Recent studies on male infertility reveal a growing worry: more infertile men are dealing with inflammation in the testis. Analyzing testicular biopsies from infertile men highlights a significant presence of inflammation. This connection, supported by clinical and pathological evidence, emphasizes that testicular inflammation hampers sperm production, leading to lasting declines in sperm count and quality. However, the exact reasons behind male infertility due to orchitis, a type of testicular inflammation, are still uncertain. Understanding these fundamental aspects of molecular signals and cellular mechanisms in testicular inflammation is crucial. Our review delves into recent literature with a dual objective: elucidating potential mechanisms involving immune cells, non-immune cells, and cytokines that link orchitis to male infertility, while also paving the way for precise interventions and solutions to address the challenges of male infertility.
PubMed: 38449458
DOI: 10.5534/wjmh.230270 -
Infectious Diseases of Poverty Mar 2024Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the...
BACKGROUND
Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.
METHODS
We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain. Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire.
RESULTS
We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18-76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11-21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive for Schistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results: pelvic pain (45.2%; OR = 1.57, 95% CI: 1.0-2.4), pain on ejaculation (14.5%; OR = 1.85, 95% CI: 1.0-3.5), dyspareunia (12.4%; OR = 2.45, 95% CI: 1.2-5.2), erectile dysfunction (9.5%; OR = 3.10, 95% CI: 1.3-7.6), self-reported episodes of infertility (32.1%; OR = 1.69, 95% CI: 1.0-2.8), haematuria (55.2%; OR = 2.37, 95% CI: 1.5-3.6), dysuria (52.1%; OR = 2.01, 95% CI: 1.3-3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%; OR = 1.81, 95% CI: 1.0-3.1). Clinical signs tended to cluster.
CONCLUSIONS
Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.
Topics: Adult; Female; Male; Humans; Spain; Cross-Sectional Studies; Prospective Studies; Transients and Migrants; Schistosomiasis
PubMed: 38449032
DOI: 10.1186/s40249-024-01190-8 -
Urology Case Reports Mar 2024This report documents the first case of Raoultella planticola epididymo-orchitis following campylobacter gastroenteritis in a 76-year-old male. Highlighting R....
This report documents the first case of Raoultella planticola epididymo-orchitis following campylobacter gastroenteritis in a 76-year-old male. Highlighting R. planticola's expanded pathogenic potential beyond common urinary tract infections, this case emphasizes its clinical significance in atypical genitourinary presentations, particularly in individuals with pre-existing conditions like diabetes mellitus and renal failure. Despite intrinsic ampicillin resistance, targeted ciprofloxacin treatment proved effective. This case underscores the necessity for broad diagnostic considerations and tailored antibiotic therapy in managing complex infections, advocating for increased awareness of emerging resistant uropathogens in clinical practice.
PubMed: 38404681
DOI: 10.1016/j.eucr.2024.102684 -
Microbiology Spectrum Apr 2024is a zoonotic intracellular bacterium that poses threats to human health and economic security. Intracellular infection is a hallmark of the agent and a primary cause...
is a zoonotic intracellular bacterium that poses threats to human health and economic security. Intracellular infection is a hallmark of the agent and a primary cause of distress, through which the bacterium regulates the host intracellular environment to promote its own colonization and replication, evading host immunity and pharmaceutical killing. Current studies of intracellular processes are typically premised on bacterial phenotype such as intracellular bacterial survival, followed by biochemical or molecular biological approaches to reveal detailed mechanisms. While such processes can deepen the understanding of -host interaction, the insights into host alterations in infection would be easily restricted to known pathways. In the current study, we applied CRISPR Cas9 screen to identify host genes that are most affected by infection on cell viability at the genomic level. As a result of CRISPR screening, we firstly identified that knockout of the negatively selected genes , , , and attenuate the viability of both the host cells and intracellular , suggesting these genes to be potential therapeutic targets for control. In particular, knockout of diminished intracellular survival by altering host cell autophagy. Conversely, knockout of positive screening genes promoted intracellular proliferation of . In summary, we screened host genes at the genomic level throughout infection, identified host genes that are previously not recognized to be involved in infection, and provided targets for intracellular infection control.IMPORTANCE is a Gram-negative bacterium that infects common mammals causing arthritis, myalgia, neuritis, orchitis, or miscarriage and is difficult to cure with antibiotics due to its intracellular parasitism. Therefore, unraveling the mechanism of -host interactions will help controlling infections. CRISPR-Cas9 is a gene editing technology that directs knockout of individual target genes by guided RNA, from which genome-wide gene-knockout cell libraries can be constructed. Upon infection with , the cell library would show differences in viability as a result of the knockout and specific genes could be revealed by genomic DNA sequencing. As a result, genes affecting cell viability during infection were identified. Further testing of gene function may reveal the mechanisms of -host interactions, thereby contributing to clinical therapy.
Topics: Animals; Humans; Brucella; Brucellosis; Gene Editing; Mammals
PubMed: 38376367
DOI: 10.1128/spectrum.03383-23 -
Cureus Jan 2024(NS) oil has been used as an ointment for relief from abscesses, nasal ulcers, orchitis, eczema, and swollen joints. The nutritional and biological values of wheat germ...
BACKGROUND AND OBJECTIVE
(NS) oil has been used as an ointment for relief from abscesses, nasal ulcers, orchitis, eczema, and swollen joints. The nutritional and biological values of wheat germ oil (WGO) are imperative points for testing its wound healing properties in traumatic ulcer. The aim of the study was to evaluate and compare the ability of NS versus WGO in promoting the healing of induced traumatic ulcer in albino rats clinically and histologically.
MATERIALS AND METHODS
This study was carried out after the approval of the Research Ethics Committee (REC) of the Faculty of Dentistry, Suez Canal University, in Ismailia, Egypt, on 60 albino rats with induced labial ulcer according to calculated sample size. All animals were anaesthetized with an intraperitoneal injection of 10% ketamine. The ulcer was produced on the labial mucosa corresponding to the midline between the lower two incisors of each rat. After induction of the ulcer, rats were randomly divided into four groups according to the treatment medicament: Group A (negative control group): 15 rats which remained without treatment; Group B (positive control): 15 rats which received daily a topical application of 1 ml of cetylpyridinium chloride (CPC) and lidocaine gel; Group C (NS group): 15 rats which received a daily topical application of 1 mm of NS oil painted by a brush covering the whole area of the ulcer; and Group D (WGO group): 15 rats which received 1 mm of WGO. The ulcers were measured using a digital caliper and were recorded using a digital camera at days 0, 3, 7, and 9, the largest (D) and smallest (d) diameters of the lesion were recorded, and the ulcer area was calculated using the following formula: A=π×D/2×d/2. Tissue samples were taken for histological examination, and the labial mucosa was dissected out and embedded in paraffin wax blocks. The blocks were cut with microtome to obtain sections of 4-5 μm thickness to be stained with hematoxylin and eosin stain and Masson's trichrome stain. All sections were examined under a light microscope, and the presence of inflammatory cells and collagen tissue remodeling were evaluated.
RESULTS
Within the control group, there are statistically non-significant changes in the mean of the surface area of ulcer when comparing changes in 10 rats who survived till the seventh day and inflammatory cell count when comparing changes in five rats who were sacrificed at the seventhday. There was a significant decrease in surface area and inflammatory cell count in five rats who survived till the ninth day. Within the WGO group only, all survived rats had healed ulcer at the ninth day. There is a significant decrease in inflammatory cell count in five rats who survived till the ninth day.
CONCLUSION
WGO was significantly more effective in the treatment of animal-induced ulcer compared to NS oil or CPC and lidocaine oral gel.
PubMed: 38371095
DOI: 10.7759/cureus.52432