Materiały źródłowe

• #1 Orchitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553165/

  Orchitis is defined as the inflammation of the testicle unilaterally or bilaterally usually caused by viruses and bacteria. […] Orchitis is the inflammation of the testis, and isolated acute orchitis is a very rare phenomenon. […] The primary route of the spread of infection to the testis is blood-borne dissemination. […] Viruses are implicated as significant pathogens. […] Common risk factors include a preexisting history of epididymitis, unprotected sexual contact, multiple sexual partners, long-term use of foley catheter, bladder outlet obstruction, structural abnormality, and lack of immunization with MMR vaccination (vaccination reduces the risk of developing orchitis after mumps). […] There are also reports of orchitis caused by autoimmunity, which can classify as primary and secondary.

• #1 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  Epididymitis and orchitis are inflammation of the epididymis and testes, respectively, with or without infection. These conditions can be subclassified as acute, subacute, or chronic based on symptom duration. In acute epididymitis, symptoms are present for less than six weeks and are characterized by pain and swelling. Chronic epididymitis is characterized by pain, generally without swelling, that persists for more than three months. Orchitis usually occurs when the inflammation from the epididymis spreads to the adjacent testicle. […] Epididymitis is the most common cause of intrascrotal inflammation, and retrograde ascent of pathogens is the usual route of infection. Although epididymitis was historically thought to be caused by chemical irritation from urine reflux, a study published in 1979 showed that bacteria were responsible for most cases. The study also showed that the type of bacteria varied with patient age.

• #2 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  Epididymitis and orchitis are inflammation of the epididymis and testes, respectively, with or without infection. These conditions can be subclassified as acute, subacute, or chronic based on symptom duration. In acute epididymitis, symptoms are present for less than six weeks and are characterized by pain and swelling. Chronic epididymitis is characterized by pain, generally without swelling, that persists for more than three months. Orchitis usually occurs when the inflammation from the epididymis spreads to the adjacent testicle. […] Epididymitis is the most common cause of intrascrotal inflammation, and retrograde ascent of pathogens is the usual route of infection. Although epididymitis was historically thought to be caused by chemical irritation from urine reflux, a study published in 1979 showed that bacteria were responsible for most cases. The study also showed that the type of bacteria varied with patient age.

• #2 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  With the exception of viral diseases, genitourinary tract infections seldom primarily involve the testis. Orchitis usually occurs in patients with concurrent epididymitis, and the causative pathogens of the conditions are similar. Blood-borne dissemination is the major route of isolated testicular infection. Mumps is the most common cause of viral orchitis (orchitis occurs in 20 to 30 percent of men with mumps infection). Pyogenic orchitis usually is caused by an inflammatory process in the epididymis.

• #3 Pathophysiology – RCEMLearning India

  https://www.rcemlearning.org/modules/lets-twist-againthe-acute-scrotum-and-torsion/lessons/epididymo-orchitis/topic/pathophysiology-4/

  There is spread of infection locally, either from the urinary tract (urethra or bladder) through the ejaculatory duct, seminal vesicle and the vas deferens. Infection can also spread from other sites via the blood or lymphatics. This causes inflammation involving the epididymis (epididymitis), the testicle (orchitis) or both (epididymo-orchitis). […] Mumps is another causative agent to consider in the appropriate clinical context. […] STIs: Most commonly C. trachomatis or N. gonorrhoea in the sexually active, and epididymo-orchitis may present as a progression of untreated infections. Enteric coliforms are implicated MSM patients and T. pallidum is a rarer cause of infection. […] UTIs: Commonly coliforms, with catheterisation being a precipitating factor. Also consider underlying urological issues such as calculus or obstruction. Rarer causes could include M. tuberculosis with a local (e.g. renal, prostatic) infectious source.

• #4 Epididymoorchitis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Epididymoorchitis_pathophysiology

  Epididymoorchitis refers to the inflammation of the epididymis and/or testes, with or without infection. While the pathogenesis is not fully understood, infectious epididymoorchitis is thought to be due to retrograde reflux of infected urine into the epididymis, which then spreads to the testes. […] While the pathogenesis is not fully understood, the following are the proposed mechanisms behind epididymoorchitis: […] The retrograde ascent of infectious pathogens is the usual route of infection. Most cases of epididymoorchitis start with inflammation of the epididymis (i.e., epididymitis), which then spread to the adjacent testicle (i.e., orchitis). Because orchitis tends to occur in patients with concurrent epididymitis, cases are mostly referred to as epididymoorchitis. […] Isolated cases of orchitis are usually due to mumps virus and in isolated cases of orchitis, blood-borne dissemination is the usual route of infection.

• #5 Orchitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860

  Orchitis refers to infection or swelling and irritation, called inflammation, of one or both testicles. Infections are common causes of orchitis. These include sexually transmitted infections (STIs) and infection with the mumps virus. […] Infection with a virus or bacteria can cause orchitis. Sometimes a cause can’t be found. […] Most often, bacterial orchitis is linked with or is the result of epididymitis. An infection of the urethra or bladder that spreads to the epididymis most often causes epididymitis. Sometimes, an STI is the cause. But this is a less common cause of orchitis in adults. […] The mumps virus most often causes viral orchitis. Nearly one-third of people assigned male at birth who get the mumps after puberty get orchitis. This most often happens 4 to 7 days after the mumps start.

• #5 Orchitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orchitis/symptoms-causes/syc-20375860

  Factors that raise the risk of orchitis include untreated conditions that block the urinary tract. These include prostate enlargement or scar tissue in the urethra, called urethral stricture. […] The main risk factor for mumps orchitis is not getting the mumps vaccine. […] Most often, orchitis gets better with supportive care. It can take several weeks or months before the pain and swelling go away. Rarely, complications of orchitis may include infertility. Sometimes, orchitis can cause you to not be able to have a child, called infertility. Or it can cause the body to make too little testosterone, a condition called hypogonadism. But these are less likely to happen if orchitis affects only one testicle.

• #6 Epididymitis and Orchitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0401/p583.html

  With the exception of viral diseases, genitourinary tract infections seldom primarily involve the testis. Orchitis usually occurs in patients with concurrent epididymitis, and the causative pathogens of the conditions are similar. Blood-borne dissemination is the major route of isolated testicular infection. Mumps is the most common cause of viral orchitis (orchitis occurs in 20 to 30 percent of men with mumps infection). Pyogenic orchitis usually is caused by an inflammatory process in the epididymis.

• #7 Orchitis – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/penile-and-scrotal-disorders/orchitis

  Isolated orchitis (ie, infection localized to the testes) is nearly always viral in origin, and most cases are due to mumps. […] Most bacterial orchitis is the result of severe bacterial epididymitis extending to the testis (epididymo-orchitis). […] Orchitis develops in 20 to 25% of males with mumps; 80% of cases occur in patients 10 years. […] Sixty percent of patients with mumps orchitis develop testicular atrophy in at least one testis. […] Atrophy is unrelated to fertility or to the severity of the orchitis. […] The incidence of tumor does not appear to be increased. […] Fertility is diminished in one fourth of men after unilateral mumps orchitis and in two thirds of men who have had bilateral disease. […] Other infectious agents cause similar symptoms with speed of onset and intensity related to their pathogenicity.

• #8 Mumps Orchitis: Clinical Aspects and Mechanisms – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33815357/

  The pathogenesis of mumps orchitis remains largely unclear due to lack of systematic clinical data analysis and animal models studies. […] Recent studies have revealed the mechanisms by which MuV-host cells interact and MuV infection induces inflammatory responses in testicular cells. […] MuV triggers Toll-like receptor 2 (TLR2) and cytosolic RNA sensors MDA5/RIG-I signaling pathways, thereby inducing the expression of various immunoregulatory cytokines, including pro-inflammatory factors TNF- and IL-6, chemokines CXCL10 and MCP-1, and type 1 interferons INF- and IFN-. […] MuV infection also induces the production of CXCL10, MCP-1, TNF- and IL-6 by testicular macrophages (TM). […] CXCL10 produced by SC in response to MuV infection induces apoptosis of germ cells, whereas TNF- disrupts blood-testis barrier (BTB) integrity and permeability. […] MuV infection of LC inhibits testosterone synthesis. […] MuV-induced TNF- is presumably responsible for the MuV inhibition of testosterone synthesis. […] MCP-1 and CXCL10 produced by SC, LC and TM may recruit leukocytes (L), resulting in orchitis.

• #9 Orchitis: Causes, Symptoms, Diagnosis, and Treatment Options

  https://www.metropolisindia.com/blog/preventive-healthcare/orchitis-causes-symptoms-and-treatment-of-testicular-inflammation

  Orchitis causes range from viral to bacterial infections. […] Viral orchitis causes often include the mumps virus, a primary contributor, but other viruses like measles, influenza, Epstein-Barr, varicella-zoster, and coxsackievirus can also lead to orchitis. […] Bacterial orchitis causes usually result from infections spreading from the urinary tract or epididymis. Common bacteria responsible include E. coli and Staphylococcus species, and sexually transmitted infections like gonorrhoea and chlamydia are also common culprits. […] Both viral and bacterial causes can trigger pain and inflammation in the testes, so proper diagnosis is essential to determine the underlying orchitis cause and start appropriate treatment. […] Timely orchitis diagnosis and appropriate treatment are essential to reduce the risk of these complications and preserve overall testicular health.

• #10 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  Epididymo-orchitis has also been reported as an adverse effect of amiodarone but this is a rare side-effect of amiodarone. […] Viral: mumps orchitis is most common. Coxsackievirus A, varicella and echoviral infections are rare. […] Bacterial and pyogenic infections (E. coli, Klebsiella, Pseudomonas, Staphylococcus and Streptococcus species) are unusual. […] Granulomatous (syphilis, TB, leprosy, Actinomyces spp. and fungal diseases) are rare. […] Epididymo-orchitis complications are more often seen in patients with uropathogen-related epididymo-orchitis than STI-associated epididymo-orchitis.

• #10 Epididymo-orchitis: Causes and Treatment | Doctor

  https://patient.info/doctor/epididymo-orchitis-pro

  Acute epididymo-orchitis is a clinical syndrome consisting of pain, swelling and inflammation of the epididymis, with or without inflammation of the testes. The most common route of infection is local extension and is mainly due to infections spreading from the urethra (sexually transmitted infections (STIs)) or from the bladder. Orchitis (infection limited to the testis) is much less common. Chronic epididymitis refers to epididymal pain and inflammation (usually without scrotal swelling) that lasts for more than six months. […] In men under 35 years old, infection is most often due to a sexually transmitted pathogen – eg, Chlamydia trachomatis and Neisseria gonorrhoeae. […] In men over 35 years old, infection is most often due to a non-sexually transmitted Gram-negative enteric organism causing urinary tract infections – eg, Escherichia coli, Pseudomonas spp. Specific risk factors include recent instrumentation or catheterisation.

• #11 Epididymitis – Clinical Features – Management – TeachMeSurgery

  https://teachmesurgery.com/urology/genital-tract/epididymitis/

  Epididymo-orchitis is usually caused by local extension of infection from the lower urinary tract (bladder and urethra), either via enteric (i.e. classic UTI) or non-enteric (i.e. sexually transmitted) organisms. […] In males aged 35 years old, the most likely mechanism is sexual transmission, therefore the most common organisms* are N. gonorrhoeae and C. trachomatis. […] In males aged 35 years old, an enteric organism from a urinary tract infection is the more likely mechanism of the disease**. Therefore, the most common pathogens are E. coli, Proteus spp., Klebsiella pneumoniae, and Pseudomonas aeruginosa. […] This is often secondary to a bladder outflow obstruction from prostatic enlargement, leading to retrograde ascent of the pathogen.

• #12 Immunoregulation in the testis and its implication in fertility and infections

  https://www.explorationpub.com/Journals/ei/Article/100321

  The immune privilege status of human testis protects the germ cells from an immune attack, it can also make the testis a susceptible reservoir for viruses such as human immunodeficiency virus-1, Zika virus and severe acute respiratory syndrome coronavirus-2, all of which have adverse consequences on male reproduction. […] In the testis, the auto-antigenic germ cells are protected from immune attack by its unique structural components as well as local and systemic tolerance mechanisms. […] The blood-testis barrier (BTB) is one of the tightest blood-tissue barricade in mammals. […] However, it is now amply clear that the BTB is just one of the contributing factors towards the immune privilege in the testis. […] Recent studies have suggested that not all antigens on the developing germ cells may be sequestered from the immune system.

• #13 Orchitis the Strange, the Rare and the Unusual: Case Report and Review of the Literature

  https://clinmedjournals.org/articles/iauc/international-archives-of-urology-and-complications-iauc-3-025.php

  Orchitis are classified as granulomatous and non-granulomatous orchitis. Several agents are responsible for inflammatory and infective diseases of the testis, causing orchitis. The most common clinical features are scrotal swelling, mass and/or pain. The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. Bacterial orchitis are characterized by diffuse enlargement and hyperemia usually without discrete mass. […] Granulomatous orchitis is a rare disease, first described by Grunberg in 1926. The most common clinical features that characterize granulomatous orchitis are scrotal swelling, mass and/or pain. The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. Testis is defined as a 'sanctuary organ’ since there is a blood-testis-barrier or more correctly a 'Sertoli cell barrier’, which, on one hand is a mechanism of protection of the sperm against any autoimmune reaction and on the other hand inhibits the passage of several cytotoxic agents and drugs into the testicular tissue. The blood-testis-barrier can be damaged by traumas, infections, torsion etc. One hypothesized causal factor of granulomatous orchitis is the extravasation of sperm within the testis as a consequence of discontinuation of the blood-testis-barrier resulting in a secondary granulomatous reaction due to activation of the autoimmune response.

• #13 Orchitis the Strange, the Rare and the Unusual: Case Report and Review of the Literature

  https://clinmedjournals.org/articles/iauc/international-archives-of-urology-and-complications-iauc-3-025.php

  Granulomatous orchitis either from a specific infectious may result also to be idiopathic. The idiopathic orchitis is characterized by a chronic inflammation in the interstitium and by the destruction of spermatogenic cells. The etiology is unknown, although an autoimmune or posttraumatic reaction has been hypothesized. Sonographic features include a diffuse hypoechoic aspect of the testis or focal hypoechoic intratesticular areas. […] Not all lumps indicate the presence of testicular cancer, most are caused by benign, conditions such as injury, birth defects, infection, varicocele, hydrocele, epididymal abnormalities, testicular torsion, hernia etc. An ultrasound evaluation should be enough to find out several of those pathologies, even if a correct final diagnosis is often reached by a surgical approach only. The knowledge of all kind of orchitis that may be encountered is of paramount importance to avoid unnecessary orchiectomy.

• #14 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.230270

  In individuals with normal spermatogenesis, MCs are typically observed around blood vessels in Leydig. […] Inflammatory cytokines stimulate oxidative stress within Sertoli cells and destroy the integrity of BTB, which was proved in orchitis caused by Brucellosis. […] The role of TGF- in Sertoli cells, both in vivo and in vitro, tends to lean towards being a negative regulator of immune responses. […] The complexity of this process underscores the critical importance of orchitis treatment and management in addressing male infertility issues.

• #14 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.230270

  The immune response initiates the migration of immune cells to the infection site to eradicate it. Throughout this process, various cells and cytokines play a vital role in influencing the health of the testes. […] In the EAO model, immune cells infiltrate the interstitial tissue, resulting in the generation of autoantibodies targeting testicular antigens and the production of M1 mediators, and an imbalance in steroidogenesis, resulting in decreased serum testosterone levels. […] When an infection or inflammation reaches a point where it affects organs, macrophages initially adopt the M1 phenotype, releasing cytokines like tumor necrosis factor-alpha (TNF-), interleukin (IL)-12, IL-1, and IL-23 in response to the stimulus. […] If the M1 phase persists, it can result in tissue damage, Therefore, M2 macrophages play a crucial role by secreting significant amounts of IL-10 as well as transforming growth factor-beta (TGF-), which act to dampen inflammation, facilitate tissue repair, contribute to remodeling, promote angiogenesis, and maintain internal homeostasis.

• #14 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.230270

  In the context of orchitis, the heightened expression of TNF triggers Sertoli cells to secrete increased levels of activin A and CCL2. […] The nitric oxide (NO)-nitric oxide synthase system is closely associated with testicular inflammation and the compromise of testicular function. […] In cases of chronic orchitis that ultimately result in infertility, T-lymphocytic infiltration was identified in more than half of the cases. […] In the context of inflammation, infection, or injury affecting the testicles, T cells can generate M1 cytokines. […] The quantity of tissue-resident memory T cells significantly decreased in the testis of BATF3/ mice, which resulted in the absence of notable inflammation in the EAO model of BATF3/ mice. […] Inflammatory responses in both infected and autoimmune conditions lead to the infiltration of and T cells within the testes.

• #14 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.230270

  Recent studies on male infertility reveal a growing worry: more infertile men are dealing with inflammation in the testis. […] 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. […] Orchitis can take two forms: acute with noticeable symptoms or chronic without apparent symptoms. […] Its important to note that testis epithelium lacks regenerative capabilities, which means that infections in these organs, along with their resulting inflammatory effects, often lead to permanent damage.

• #15 Autoimmune orchitis: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/autoimmune-orchitis

  Autoimmune orchitis is an extremely rare condition that affects males. In autoimmune orchitis, one or both testicles become inflamed. The immune system may produce anti-sperm antibodies, significantly impairing male fertility. […] In autoimmune orchitis, though, an autoimmune reaction causes the inflammation, and the immune system mistakenly attacks the testicles. This can cause fertility problems and other complications. […] The immune system produces anti-sperm antibodies that attack sperm, the basement membrane, and the tubules in the testicles. […] Between 5% and 12% of males with infertility have these harmful antibodies that damage the testicles and cause sperm abnormalities. This makes the sperm unable to fertilize an egg. […] Around 50% of people with secondary autoimmune orchitis have anti-sperm antibodies. This is particularly common in people with systemic lupus erythematosus.

• #15 Autoimmune orchitis: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/autoimmune-orchitis

  Experts are unsure exactly what causes autoimmune orchitis. It is possible that one of the following factors may trigger an immune response and lead to the production of antibodies against sperm cells: inflammation, infection, trauma to the testicles. […] The role of autoimmune conditions in autoimmune orchitis is unclear. […] Research into this condition aims to help improve diagnostic methods and treatment guidelines.

• #16 Orchitis the Strange, the Rare and the Unusual: Case Report and Review of the Literature

  https://clinmedjournals.org/articles/iauc/international-archives-of-urology-and-complications-iauc-3-025.php?jid=iauc

  Orchitis are classified as granulomatous and non-granulomatous orchitis. Several agents are responsible for inflammatory and infective diseases of the testis, causing orchitis. The most common clinical features are scrotal swelling, mass and/or pain. The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. Bacterial orchitis are characterized by diffuse enlargement and hyperemia usually without discrete mass. […] Granulomatous orchitis is a rare disease, first described by Grunberg in 1926. The most common clinical features that characterize granulomatous orchitis are scrotal swelling, mass and/or pain. The diagnosis is mainly histological because clinical and sonographic aspects may be not conclusive. Testis is defined as a 'sanctuary organ’ since there is a blood-testis-barrier or more correctly a 'Sertoli cell barrier’, which, on one hand is a mechanism of protection of the sperm against any autoimmune reaction and on the other hand inhibits the passage of several cytotoxic agents and drugs into the testicular tissue. The blood-testis-barrier can be damaged by traumas, infections, torsion etc. One hypothesized causal factor of granulomatous orchitis is the extravasation of sperm within the testis as a consequence of discontinuation of the blood-testis-barrier resulting in a secondary granulomatous reaction due to activation of the autoimmune response.

• #16 Orchitis the Strange, the Rare and the Unusual: Case Report and Review of the Literature

  https://clinmedjournals.org/articles/iauc/international-archives-of-urology-and-complications-iauc-3-025.php?jid=iauc

  Granulomatous orchitis either from a specific infectious may result also to be idiopathic. The idiopathic orchitis is characterized by a chronic inflammation in the interstitium and by the destruction of spermatogenic cells. The etiology is unknown, although an autoimmune or posttraumatic reaction has been hypothesized. Sonographic features include a diffuse hypoechoic aspect of the testis or focal hypoechoic intratesticular areas. […] Lastly, vasculitis like polyangiitis, a systemic necrotizing granulomatous vasculite, may rarely (less than 1% of cases) affects the genitourinary system causing prostatis, urethritis, orchitis and renal injuries. In this case, serologic evaluation of antineutrophil cytoplasmatic antibodies (ANCA) may be important in the differential diagnosis.

• #17 Causes of Orchitis, Differential Diagnosis, and Treatment of Mumps Orchitis

  https://www.urology-textbook.com/mumps-orchitis.html

  Orchitis leads to infiltration of lymphocytes, damage to the blood-testis barrier, and edema with the rise of intratesticular pressure with pressure atrophy (caused by the inelastic tunica albuginea). […] Infertility, subfertility, and hypogonadism may develop depending on the extent of the (bilateral) disease. […] Bilateral orchitis may cause testicular atrophy with infertility, in severe cases with hypergonadotropic hypogonadism.

• #18 Disease of Testes of Bulls

  http://vetrepropath.com/male/Male_bovine/bull_testis.html

  Interstitial orchitis may not be recognized macroscopically, but histologically there are lymphocytes in the interstitial stroma, with concurrent or subsequent fibrosis. […] The best descriptions of orchitis are of Brucella abortus infection in endemic regions. In most instances, the orchitis is acute and severe. […] The inflammation of the tunics results in extremely dense adhesions between the parietal and visceral layers. Within the testes, the infection appears to progress along the lumen of the seminiferous tubules. […] The seminal epithelium becomes necrotic and desquamates. […] The causes of testicular atrophy degeneration are legion. Here are some of the known causes, and some are discussed further below. […] Mainenance of the seminiferous epithelium requires a close intergration of pituitary hormones, systemic and local environments, and of the crosstalk between germ cell, Sertoli cell and interstitial endocrine cell. Injury to any one of these ill upset the equilibrium necessary for normal spermatogenesis.

• #18 Disease of Testes of Bulls

  http://vetrepropath.com/male/Male_bovine/bull_testis.html

  From a pathology point of view, orchitis is inflammation of the testis. Clinically though, orchitis is used to indicate any disease of the scrotal contents, including periorchitis, epididymitis and orchitis itself. […] Lymphocytic (or nonsuppurative) inflammation is seen in some infertile animals; an immunological pathogenesis is invoked as immunization of guinea pigs and bulls with spermatozoa induced inflammation of the rete testes especially. Efferent ductules are also involved experimentally. […] Orchitis as the primary and severe disease has historically been attributed to brucellosis or tuberculosis. Tuberculous orchitis is a multifocal granulomatous disease that is much less common now because of eradication in many countries. Brucellosis is similarly reduced in prevalence. Brucella abortus, causes orchitis as a dominant change.

• #19 Orchitis: Causes, symptoms., treatment

  https://www.medicalnewstoday.com/articles/orchitis

  Orchitis is an inflammation of one or both testicles. It can cause swelling and tenderness and commonly results from an underlying viral or bacterial infection. Most cases resolve within 10 days. […] Orchitis typically does not occur in isolation, meaning that it often accompanies another condition. Most commonly, it occurs due to a viral or bacterial infection. […] While viruses or bacteria can cause orchitis, the most common cause is mumps. When mumps is the cause, orchitis typically develops 4 to 6 days after infection. […] Treatment and management for orchitis can vary depending on the exact cause. Some common treatment options doctors may recommend include pain and anti-inflammatory medications, bed rest, and ice packs. […] In cases of bacterial infection, a doctor will likely recommend antibiotics to treat the infection. These antibiotics will differ according to whether an STI or another bacterium is causing the swelling. […] Most cases resolve within 10 days. […] Though most people recover with no issues, some do develop complications relating to orchitis. Some possible complications include infertility, scrotal abscess, chronic epididymitis, fistula on the skin of the scrotum, and death of testicle tissue.

• #20 Orchitis | PPT

  https://www.slideshare.net/slideshow/orchitis-232901738/232901738

  Orchitis is an inflammation of the testicles that is usually caused by a bacterial or viral infection. Common causes include mumps, STDs like chlamydia and gonorrhea, and infections that spread from other parts of the body through the bloodstream. […] Orchitis may be caused by the virus that causes Mumps, STDs or other causes. At least one-third of males who contract mumps after puberty often develop orchitis. […] Etiology: Pyogenic bacteria Gonococci Tubercle Bacilli or Viruses. Trauma Infections Mononucleosis Prostatectomy Epididymitis Catheterization or UTI Influenza Mumps and Syphilis. […] Pathophysiology: Due to the etiological factor Inflammatory fluid seeks the testicle into the serus membrane (lining epididymis and the testicles) Unilateral or Bilateral Swelling. […] Complication: Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy). Orchitis may also cause infertility. Other potential complications include: Chronic epididymitis. Death of testicle tissue (testicular infarction). Fistula on the skin of the scrotum (cutaneous scrotal fistula). Scrotal abscess. Acute pain in the scrotum or Torsion, which is a surgical emergency. […] Prevention: Getting vaccinated against mumps will prevent mumps-associated orchitis. Safer sex behaviors, such as having only one partner at a time (monogamy) and condom use, will decrease the chance of developing orchitis as a result of a STI.

• #21 Orchitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/orchitis

  Getting the right diagnosis and treatment for orchitis caused by bacteria can most often allow the testicle to recover normally. […] Mumps orchitis has no effective treatment, and the outcome can vary. Men who have had mumps orchitis can become sterile. […] Some boys who get orchitis caused by mumps will have shrinking of the testicles (testicular atrophy). […] Orchitis may also cause infertility.

• #21 Orchitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/orchitis

  Orchitis may be caused by an infection. Many types of bacteria and viruses can cause this condition. […] The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis most often develops 4 to 6 days after the mumps begins. […] Orchitis may also occur along with infections of the prostate or epididymis. […] Orchitis may be caused by a sexually transmitted infection (STI), such as gonorrhea or chlamydia. The rate of sexually transmitted orchitis or epididymitis is higher in men ages 19 to 35. […] Risk factors for sexually transmitted orchitis include: High-risk sexual behaviors, Multiple sexual partners, Personal history of gonorrhea or another STI, Sexual partner with a diagnosed STI. […] Risk factors for orchitis not due to an STI include: Being older than age 45, Long-term use of a Foley catheter, Not being vaccinated against the mumps virus, Problems of the urinary tract that were present at birth (congenital), Repeated urinary tract infections, Surgery of the urinary tract (genitourinary surgery), BPH (benign prostatic hyperplasia) – enlarged prostate, Urethral stricture (scarring inside urinary tract that causes narrowing of the passageway).

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