In more than 50% of cases, infections affect both the testis and the epididymis (orchioepididymitis). Infections can be divided into acute and chronic depending on the etiologic agent and the duration of infection. Germs reach testis and epididymis in several ways: hematogenous, retrograde if there is urine reflux seminal vesicle-epididymis, lymphatic, or direct from a trauma or wound. Germs that arrive by hematogenous route affect the testicle and produce orchitis. Infectious agents that reach through excretory ducts lead to epididymitis (Nistal et al. 2016).
Epididymitis and Acute Orchioepididymitis
Clinically, the epididymis or, where appropriate, the testicle are congestive, thickened, edematous with fibrinopurulent exudate. The most frequent etiology is bacterial, followed by viral and those caused by parasites.
Bacterias: In childhood, bacterial germs that cause epididymitis are preferably coliforms, in young adults, Neisseria gonorrhoeae and Chlamydia trachomatisand in elder...
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References and Further Reading
Bosilkovski, M., Kamiloski, V., Miskova, S., Balalovski, D., Kotevska, V., & Petrovski, M. (2018). Testicular infection in brucellosis: Report of 34 cases. Journal of Microbiology, Immunology, and Infection, 51, 82–87.
Janssen, K. M., Willis, C. J., Anderson, M., Gelnett, M. S., Wickersham, E. L., & Brand, T. C. (2017). Filariasis Orchitis-differential for acute scrotum pathology. Urology Case Reports, 13, 117–119.
Moazenchi, M., Totonchi, M., Salman Yazdi, R., Hratian, K., Mohseni Meybodi, M. A., Ahmadi Panah, M., Chehrazi, M., & Mohseni Meybodi, A. (2018). The impact of chlamydia trachomatis infection on sperm parameters and male fertility: A comprehensive study. International Journal of STD & AIDS, 29, 466–473.
Nistal, M., Paniagua, R., González-Peramato, P., & Reyes-Múgica, M. (2016). Perspective in pediatric pathology, chapter 24. Testicular inflammatory processes in pediatric patients. Pediatric and Developmental Pathology, 19, 460–470.
Ryan, L., Daly, P., Cullen, I., & Doyle, M. (2018). Epididymo-orchitis caused by enteric organisms in men > 35 years old: Beyond fluoroquinolones. European Journal of Clinical Microbiology & Infectious Diseases, 37, 1001–1008.
Yamashita, S., Umemoto, H., Kohjimoto, Y., & Hara, I. (2017). Xanthogranulomatous orchitis after blunt testicular trauma mimicking a testicular tumor: A case report and comparison with published cases. Urology Journal, 14, 3094–3096.
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Nistal, M., González-Peramato, P. (2020). Infectious Disease of the Testis. In: Raspollini, M.R., Lopez-Beltran, A. (eds) Uropathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-41894-6_4830
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