Acute nonspecific orchitis
Introduction
Introduction to acute non-specific orchitis Orchitis is an acute inflammatory reaction after testicular infection, usually secondary to epididymitis, bacteria through the lymph or vas deferens to the epididymis, and then spread to the testis to cause epididymal orchitis, due to testicular blood supply, simple testicles caused by bacteria Inflammation is rare. Simple orchitis is caused by mumps virus. It is also reported that Coxsackie virus and Echovirus can also cause orchitis, but it is quite rare. basic knowledge The proportion of illness: 0.013% Susceptible people: male Mode of infection: non-infectious Complications: orchitis
Cause
Acute non-specific orchitis
Causes:
Acute non-specific orchitis is caused by bacterial invasion of the testis. The infection is mainly caused by retrograde infection (invasion by the vas deferens or epididymis), mostly in lower urinary tract infections, prostatitis, and after transurethral resection. Patients with long-term indwelling catheters, causing epididymal testicular infection, can also be disseminated to the testes by blood, causing simple orchitis, but due to the rich testicular blood supply, this situation is rare, the common pathogen is Escherichia coli, Proteus, Staphylococcus, Enterococcus, Pseudomonas aeruginosa and Neisseria gonorrhoeae.
Pathogenesis:
The naked eye showed different degrees of testicular enlargement, congestion, tension, small abscess can be seen when the testis is cut, most focal necrosis can be observed under the microscope, connective tissue edema and lobular granulocyte infiltration, fine tubule inflammation, Hemorrhage, necrosis, severe testicular abscess and testicular infarction.
Prevention
Acute non-specific orchitis prevention
For patients with urinary tract infections and prostatitis, thorough and effective anti-infective treatment must be carried out to prevent the pathogen from transfecting the testicular tissue. If necessary, in order to prevent recurrent attacks, the ipsilateral vas deferens can be ligated. At the same time should pay attention to genital hygiene, young men to avoid excessive masturbation and frequent sexual life, due to sexual excitement after urethral dilatation, congestion, easy to induce orchitis due to retrograde infection.
Complication
Acute non-specific orchitis complications Complications orchitis
After the orchitis is cured, testicular atrophy can be caused by fibrosis and damage to the seminiferous tubules.
Symptom
Acute non-specific testicular symptoms Common symptoms Septic nausea and vomiting inguinal lymphadenoma
History
Have sepsis, history of epididymitis or history of urethral instrument examination and history of trauma.
2. Symptom
Pain in the scrotum and radiate to the groin, accompanied by nausea, vomiting, fever, chills.
3. Medical examination
The scrotal skin is red and swollen, the tenderness is obvious, the testicles, the epididymis are enlarged and tender, and the inguinal lymph nodes are often accompanied by testicular hydrocele.
Examine
Examination of acute non-specific orchitis
Blood routine examination: neutrophils, blood culture may have bacterial growth.
B-ultrasound examination: the testicles are swollen, and the internal echoes are medium-sized, dense, dense, point-like echoes with even distribution.
Diagnosis
Diagnosis and diagnosis of acute non-specific orchitis
According to the symptoms of systemic infection and the symptoms of the testicular red, swollen, hot, and painful, the diagnosis can be clearly confirmed.
Differential diagnosis
1. Testicular and spermatic cord torsion
Any acute scrotal pain, swelling should be thought of testicular and spermatic cord torsion, when the testicle (or spermatic cord) is reversed, the testicle usually retracts, the texture is hard, the spermatic cord becomes thicker, and it is difficult to reach on the testicle. In the early stage of the lesion, The epididymis can be touched in front of the testicles, but as the swelling and inflammation worsen, the two are gradually indistinguishable. In addition, lifting the scrotum can aggravate the pain. Color Doppler ultrasound can provide valuable information about testicular blood flow, if necessary, surgery Exploring.
2. Acute epididymitis
Early epididymal enlargement is obvious, easy to distinguish from acute orchitis, but when the inflammation spreads to the testis in the later stage, the two are difficult to distinguish.
3. Mumps orchitis
There is a history of mumps, but generally no manifestations of urinary tract infections. Checking for viral antibodies in serum helps to confirm the diagnosis.
4. Incarcerated Messenger
There may also be scrotal pain and swelling, but the scrotum has a history of retraction of the tumor above the testicular scrotum, and there may be intestinal obstruction after incarceration. There is a certain limit between the tumor and the testicle during palpation.
