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Cureus Apr 2024Even though infected vasitis is rarely reported in the literature, there are other diagnoses that share the same clinical signs, including testicular torsion,...
Even though infected vasitis is rarely reported in the literature, there are other diagnoses that share the same clinical signs, including testicular torsion, epididymo-orchitis, epididymitis, trauma, and incarcerated hernia. A 27-year-old man was brought to the emergency department by his brother with right inguinal and testicular pain for one day. The history was not significant with fever, lower urinary tract symptoms, urethral discharge, change in bowel habits, previous history of inguinal swelling, or surgical intervention. On presentation, the patient was vitally stable, and right infra-inguinal and inguinal vas deferens were tender and swollen; however, both testes and epididymis were normal, and no urethral discharge. Vasitis, or inflammation of the vas deferens, is an uncommon illness that Chan PT and Schlegel classified as either asymptomatic vasitis nodosa or severely painful infectious vasitis. Acute infective vasitis is a really uncommon illness, with only a few occurrences documented in the literature. However, the retrograde transmission of urinary pathogens such as and is thought to cause acute vasitis. Because of its rarity and ambiguous imaging findings, diagnosing vasitis can be difficult. Epididymitis, orchitis, and testicular torsion can all be ruled out with ultrasound and duplex Doppler screening. Inguinal hernia is difficult to distinguish from vasitis with ultrasound; hence, CT and MRI are more commonly used to confirm the diagnosis. Since this is the first occurrence in our city that we are aware of, it was reported. A few cases from Saudi Arabia have also been documented, and by doing so, we may raise clinicians' awareness of this disease and ensure that they can treat patients without making an incorrect diagnosis.
PubMed: 38784330
DOI: 10.7759/cureus.58785 -
Radiology Case Reports Aug 2024Vasitis is inflammation of the vas deferens, which can be divided into acute inflammatory vasitis or chronic vasitis nodosa. Acute vasitis can present with inguinal...
Vasitis is inflammation of the vas deferens, which can be divided into acute inflammatory vasitis or chronic vasitis nodosa. Acute vasitis can present with inguinal pain, swelling, or a lump, which could mimic other common pathologies occurring at this site, particularly inguinal hernia. While ultrasound is effective in the diagnosis of epididymitis, orchitis, and hernia, this case illustrates the importance of cross-sectional imaging to establish the correct diagnosis of vasitis, to aid in the prevention of unnecessary surgical exploration and to expedite antibiotic treatment. Previous surgical intervention to the prostate is the leading risk factor for vasitis and should be taken into consideration when making a differential diagnosis and determining which image modality to use. Here, we present a case of vasitis in a 60-year-old male with previous Holmium laser enucleation of the prostate (HoLEP), with an initial diagnosis of inguinal hernia on ultrasound which was later diagnosed as acute vasitis on CT.
PubMed: 38770388
DOI: 10.1016/j.radcr.2024.04.046 -
Frontiers in Microbiology 2024Globally, ~8%-12% of couples confront infertility issues, male-related issues being accountable for 50%. This review focuses on the influence of gut microbiota and their... (Review)
Review
Globally, ~8%-12% of couples confront infertility issues, male-related issues being accountable for 50%. This review focuses on the influence of gut microbiota and their metabolites on the male reproductive system from five perspectives: sperm quality, testicular structure, sex hormones, sexual behavior, and probiotic supplementation. To improve sperm quality, gut microbiota can secrete metabolites by themselves or regulate host metabolites. Endotoxemia is a key factor in testicular structure damage that causes orchitis and disrupts the blood-testis barrier (BTB). In addition, the gut microbiota can regulate sex hormone levels by participating in the synthesis of sex hormone-related enzymes directly and participating in the enterohepatic circulation of sex hormones, and affect the hypothalamic-pituitary-testis (HPT) axis. They can also activate areas of the brain that control sexual arousal and behavior through metabolites. Probiotic supplementation can improve male reproductive function. Therefore, the gut microbiota may affect male reproductive function and behavior; however, further research is needed to better understand the mechanisms underlying microbiota-mediated male infertility.
PubMed: 38765683
DOI: 10.3389/fmicb.2024.1371667 -
Cureus Apr 2024Xanthogranulomatous orchitis (XGO) is a benign non-inflammatory condition predominantly affecting the testicular tissue and characterized by the infiltration of...
Xanthogranulomatous orchitis (XGO) is a benign non-inflammatory condition predominantly affecting the testicular tissue and characterized by the infiltration of lipid-laden macrophages leading to substantial tissue damage. We present the case of an 80-year-old gentleman with chronic pyocele and concurrent testicular atrophy secondary to XGO, a seldom-reported manifestation in the testicular milieu. The patient presented with a protracted history of left-sided scrotal swelling and underwent left orchidectomy subsequent to preoperative diagnosis via ultrasonography. Intraoperative exploration revealed the presence of purulent fluid, and histopathological analysis confirmed characteristic features of XGO, including seminiferous tubule destruction and infiltration of fibroconnective tissue by histiocytes and dilated blood vessels. Differential diagnosis with testicular neoplasms posed a challenge, accentuating the pivotal role of histopathological scrutiny in achieving precise diagnosis. Orchidectomy remains the cornerstone of treatment for XGO. This case underscores the imperative of considering XGO in the diagnostic spectrum of testicular masses and the indispensable role of histopathology in confirming the diagnosis and guiding optimal therapeutic interventions.
PubMed: 38752057
DOI: 10.7759/cureus.58325 -
Cureus Apr 2024Testicular myeloid sarcoma (TMS) is a challenging pathology often posing diagnostic difficulties due to the poorly differentiated nature of tumor cells at the initial...
Testicular myeloid sarcoma (TMS) is a challenging pathology often posing diagnostic difficulties due to the poorly differentiated nature of tumor cells at the initial presentation. The delay in diagnosis significantly impacts patient life expectancy, emphasizing the need for prompt identification and treatment initiation. In certain cases, the presence of the Fms-like tyrosine kinase () mutation adds complexity to the disease, requiring tailored therapeutic approaches. In this report, we present a unique case of bilateral TMS with tyrosine kinase domain () mutation. The patient exhibited an aggressive clinical course, initially misdiagnosed with orchitis during the initial evaluation. Subsequent reevaluation of the testicular biopsy at a second center led to an accurate diagnosis, highlighting the importance of thorough examination in challenging cases. Given the emerging significance of mutations in myeloid sarcomas, comprehensive testing for all variants is crucial to determine the appropriate treatment modality. This case underscores the need for increased awareness among healthcare professionals regarding the diagnostic nuances and potential genetic variations associated with TMS. Furthermore, the inclusion of tyrosine kinase inhibitors, such as midostaurin or gilteritinib, especially in the presence of mutations, may significantly impact treatment outcomes. This report contributes to the growing body of literature on TMS and highlights the importance of considering mutations in the diagnostic and therapeutic decision-making process for improved patient care.
PubMed: 38738062
DOI: 10.7759/cureus.58140 -
Asian Journal of Andrology May 2024Infections and inflammatory reactions in the male genital tract are the leading causes of male infertility with a prevalence of 6%-10%, primarily affecting testicular...
Infections and inflammatory reactions in the male genital tract are the leading causes of male infertility with a prevalence of 6%-10%, primarily affecting testicular and epididymal function and ultimately compromising sperm quality. However, most infertile patients with genital infection/inflammation are asymptomatic and easily overlooked. Traditional indicators, including white blood cells, elastase, and other components in semen, can reflect inflammation of the genital tract, but there is still a lack of a uniform standard method of detection. Therefore, it is necessary to explore reliable markers in semen that reflect the inflammatory status of the genital tract. Using the experimental autoimmune orchitis (EAO) model to simulate noninfectious chronic orchitis, we successfully collected ejaculated seminal fluid from EAO rats using optimized electrical stimulation devices. Proteomic analysis was performed using isobaric tags for relative and absolute quantification (iTRAQ). Compared to the control group, 55 upregulated and 105 downregulated proteins were identified in seminal plasma samples from the EAO group. In a preliminary screening, the inflammation-related protein S100A8/A9 was upregulated. We further verified that S100A8/A9 was increased in seminal plasma and highly expressed in testicular macrophages of the EAO model. In patients with oligoasthenospermia and genital tract infections, we also found that S100A8/A9 levels were remarkably increased in seminal plasma and testicular macrophages. S100A8/A9 in semen may be a potential biomarker for chronic genital inflammation. Our study provides a new potential biomarker for early diagnosis and further understanding of male infertility caused by genital inflammation.
PubMed: 38727211
DOI: 10.4103/aja202389 -
Asian Journal of Surgery May 2024
PubMed: 38724387
DOI: 10.1016/j.asjsur.2024.05.006 -
Heliyon May 2024Oxidative stress refers to a condition where there is an imbalance between the production of reactive oxygen species and their removal by antioxidants. While the... (Review)
Review
Oxidative stress refers to a condition where there is an imbalance between the production of reactive oxygen species and their removal by antioxidants. While the function of reactive oxygen species as specific second messengers under physiological conditions is necessary, their overproduction can lead to numerous instances of cell and tissue damage. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a master regulator of many cytoprotective genes that respond to redox stresses. Nrf2 is regularly degraded by kelch-like ECH-associated protein 1 through the ubiquitin-proteasome pathway. The kelch-like ECH-associated protein 1 and Nrf2 complex have attracted attention in both basic and clinical infertility research fields. Oxidative stress is implicated in the pathogenesis of female infertility, including primary ovarian insufficiency, polycystic ovarian syndrome, and endometriosis, as well as male infertility, namely varicocele, cryptorchidism, spermatic cord torsion, and orchitis. Most scientists believe that Nrf2 is a potential therapeutic method in female and male infertility disorders due to its antioxidant effect. Here, the potential roles of oxidative stress and Nrf2 in female and male infertility disorders are reviewed. Moreover, the key role of Nrf2 in the inhibition or induction of these diseases is discussed.
PubMed: 38720768
DOI: 10.1016/j.heliyon.2024.e29752 -
IDCases 2024Brucellosis is an important zoonosis problem worldwide. It's also recognized as a clinical and health problem in Algeria.
INTRODUCTION
Brucellosis is an important zoonosis problem worldwide. It's also recognized as a clinical and health problem in Algeria.
METHODS
This research is a descriptive study to determine the prevalence of brucellosis and some clinical and epidemiological aspects of hospitalized patients in the agro-pastoral region of Theniet El Had for ten years, between March 2013 and March 2023. During the study period, 180 patients (61.66% men and 38.33% women) with confirmed brucellosis based on clinical symptoms and serological tests were hospitalized for treatment. Patients working with animals were requested to screen their animals (383 goats from 27 suspicious farms with no history of vaccination), 16, 71% of goats from 44%, and 44% herds were infected.
RESULTS
The occurrence of human cases varied from 49.18 to 66.02pcm (cases/100,000 inhabitants) with an average of 58, 48pcm (cases/100,000 inhabitants). Almost half of hospitalized people who had been in contact with animals could have been contaminated by direct contact. Consumption of unpasteurized dairy products during the last 2 months was at the order of 95.55%. A family history of Brucellosis was observed in 36 (20%) patients. Brucella epididymo-orchitis occurred in 18.01% while relapse occurred in a small proportion of 7.22%.
CONCLUSIONS
Local authorities should prevent human brucellosis with surveillance systems, disease declarations, biosecurity programs, and warning communities about the hazards of consumption of unpasteurized milk and dairy products.
PubMed: 38681083
DOI: 10.1016/j.idcr.2024.e01945 -
Biology Apr 2024Experimental autoimmune orchitis (EAO) is a well-established rodent model of organ-specific autoimmunity associated with infertility in which the testis...
Experimental autoimmune orchitis (EAO) is a well-established rodent model of organ-specific autoimmunity associated with infertility in which the testis immunohistopathology has been extensively studied. In contrast, analysis of testis biopsies from infertile patients associated with inflammation has been more limited. In this work, testicular biopsies from patients with idiopathic non-obstructive azoospermia diagnosed with hypospermatogenesis (HypoSp) [mild: = 9, and severe: = 11], with obstructive azoospermia and complete Sp (spermatogenesis) (control group, C, = 9), and from Sertoli cell-only syndrome (SCOS, = 9) were analyzed for the presence of immune cells, spermatogonia and Sertoli cell (SCs) alterations, and reproductive hormones levels. These parameters were compared with those obtained in rats with EAO. The presence of increased CD45+ cells in the seminiferous tubules (STs) wall and lumen in severe HypoSp is associated with increased numbers of apoptotic meiotic germ cells and decreased populations of undifferentiated and differentiated spermatogonia. The SCs showed an immature profile with the highest expression of AMH in patients with SCOS and severe HypoSp. In SCOS patients, the amount of SCs/ST and Ki67+ SCs/ST increased and correlated with high serum FSH levels and CD45+ cells. In the severe phase of EAO, immune cell infiltration and apoptosis of meiotic germ cells increased and the number of undifferentiated and differentiated spermatogonia was lowest, as previously reported. Here, we found that orchitis leads to reduced sperm number, viability, and motility. SCs were mature (AMH-) but increased in number, with Ki67+ observed in severely damaged STs and associated with the highest levels of FSH and inflammatory cells. Our findings demonstrate that in a scenario where a chronic inflammatory process is underway, FSH levels, immune cell infiltration, and immature phenotypes of SCs are associated with severe changes in spermatogenesis, leading to azoospermia. Furthermore, AMH and Ki67 expression in SCs is a distinctive marker of severe alterations of STs in human orchitis.
PubMed: 38666890
DOI: 10.3390/biology13040278