Intratesticular Abscess in a Solitary Testicle: The Case for Testicle Sparing Management

Zaid, Uwais B.; Bagga, Herman S.; Reese, Adam C.; Breyer, Benjamin N.

doi:10.1155/2013/184064

Cited by 5 publications

(10 citation statements)

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“…This bacterium tends to colonize in the intestinal tracts of humans, mammals and reptiles as part of the normal flora, and is often found in the environment (Lee et al, 2009). It is noteworthy that M. morganii is an opportunistic pathogen, but the disease spectrum associated its infections is broad, mainly including sepsis (Seija et al, 2015), abscess (Zaid et al, 2013), urinary tract infection (Jamal et al, 2015), and bacteremia (Ghosh et al, 2009). Furthermore, M. morganii can harbor ESBLs and carbapenemase, which adds resistance to multiple antibiotics and has resulted in a high mortality rate in some infections (Liu et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Detection and Genomic Characterization of a Morganella morganii Isolate From China That Produces NDM-5

et al. 2019

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The increasing prevalence and transmission of the carbapenem resistance gene bla NDM–5 has led to a severe threat to public health. So far, bla NDM–5 has been widely detected in various species of Enterobacterales and different hosts across various cities. However, there is no report on the bla NDM–5– harboring Morganella morganii. In January 2016, the first NDM-5-producing Morganella morganii L241 was found in a stool sample of a patient diagnosed as recurrence of liver cancer in China. Identification of the species was performed using 16S rRNA gene sequencing. Carbapenemase genes were identified through both PCR and sequencing. To investigate the characteristics and complete genome sequence of the bla NDM–5 -harboring clinical isolate, antimicrobial susceptibility testing, S1 nuclease pulsed field gel electrophoresis, Southern blotting, transconjugation experiment, complete genome sequencing, and comparative genomic analysis were performed. M. morganii L241 was found to be resistant to broad-spectrum cephalosporins and carbapenems. The complete genome of L241 is made up from both a 3,850,444 bp circular chromosome and a 46,161 bp self-transmissible IncX3 plasmid encoding bla NDM–5 , which shared a conserved genetic context of bla NDM–5 (ΔIS 3000 -ΔIS Aba125 -IS 5 - bla NDM–5 - ble - trpF - dsbC -IS 26 ). BLASTn analysis showed that IncX3 plasmids harboring bla NDM genes have been found in 15 species among Enterobacterales from 13 different countries around the world thus far. In addition, comparative genomic analysis showed that M. morganii L241 exhibits a close relationship to M. morganii subsp. morganii KT with 107 SNPs. Our research demonstrated that IncX3 is a key element in the worldwide dissemination of bla NDM - 5 among various species. Further research will be necessary to control and prevent the spread of such plasmids.

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Section: Introductionmentioning

confidence: 99%

Detection and Genomic Characterization of a Morganella morganii Isolate From China That Produces NDM-5

et al. 2019

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“…A similar case has recently been reported in a patient under immunosuppression. 4 Generally, the risk to acquire an epididymitis is elevated in patients with SCI due to the NLUTD. 2 The bacteria detected in the urine are usually the causative agents.…”

Section: Discussionmentioning

confidence: 99%

Organ-preserving treatment of an epididymal abscess in a patient with spinal cord injury

Pannek

Pannek-Rademacher²,

Cachin-Jus³

2014

Spinal Cord

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Study design: Case report. Objectives: To describe a case of successful organ-preserving treatment of an epididymal abscess in a tetraplegic patient. Setting: Spinal Cord Injury Rehabilitation Centre in Switzerland. Methods: We present the clinical course of a patient with an epididymal abscess caused by multiresistant bacteria. As the patient declined surgical intervention, a conservative approach was induced with intravenous antibiotic treatment. As the clinical findings did not ameliorate, adjunctive homeopathic treatment was used. Results: Under combined treatment, laboratory parameters returned to normal, and the epididymal abscess was rapidly shrinking. After 1 week, merely a subcutaneous liquid structure was detected. Fine-needle aspiration revealed sterile purulent liquid, which was confirmed by microbiological testing when the subcutaneous abscess was drained. Postoperative course was uneventful. Conclusions: As the risk for recurrent epididymitis is high in persons with spinal cord injury, an organ-preserving approach is justified even in severe cases. Homeopathic treatment was a valuable adjunctive treatment in the above-mentioned case. Therefore, prospective studies are needed to further elucidate the future opportunities and limitations of classical homeopathy in the treatment of urinary tract infections. Spinal Cord (2014) 52, S7-S8; doi:10.1038/sc.2014.50 INTRODUCTIONVirtually all patients with spinal cord injury (SCI) develop neurogenic lower urinary tract dysfunction (NLUTD). The primary goal of bladder management in patients with NLUTD as a result of suprasacral SCI is to achieve low urine storage pressure 1 in order to protect renal function.Irrespective of the method chosen for bladder management, the risk for urinary tract infection (UTI) is elevated in these persons. In men with NLUTD due to SCI, especially epididymo-orchitis is a common complication, which is found in up to 38.5% of the patients. 2 If epididymo-orchitis is complicated by abscess formation, orchiectomy or epididymectomy is the method of choice. 3 However, patients try to avoid ablative genital surgery whenever possible. We present the case of a multimodal approach of an organ-sparing treatment of an epididymal abscess.

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“…По подсчётам S. Biswas и G. , частота АЯ составляет около 1 случая на каждую 1000 случаев всех острых заболеваний органов мошонки в год [7]. Течение острого эпидидимоорхита осложняется развитием АЯ приблизительно в 4-5,5% случаев [15,29,51,54,60]. К причинам развития АЯ, возникшего как осложнение эпидидимоорхита, относятся поздняя диагностика, неадекватное лечение и клинически упорное течение острого эпидидимоорхита [5,6,13,30].…”

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“…Наиболее часто (почти три четверти случаев) АЯ развивается при прогрессировании острого эпидидимоорхита, возникшего каналикулярным путём (при распространении урогенитальной инфекции на придаток яичка путём рефлюкса мочи из уретры в семявыносящий проток). Переход воспалительного процесса на паренхиму яичка приводит к развитию очагового инфаркта яичка, который в условиях высоковирулентной инфекции и нарушенного кровообращения быстро абсцедируется [5,7,15,50,60].…”

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“…В клинической практике подозрение на АЯ обычно возникает при упорном течении острого эпидидимоорхита, не поддающегося антибактериальной терапии в течение первых 5-7 сут заболевания [3,4,50,60]. Такое нетипичное течение острого эпидидимоорхита предполагает развитие АЯ и вынуждает клинициста предпринять необходимые лучевые исследования.…”

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Testicular abscess

Prokhorov¹

2016

Kazan Med J

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In the present literature review modern view on the etiopathogenesis, clinical course, diagnosis, treatment and prognosis of testicular abscess, which is a rare disease, are described. Testicular abscess develops most often as a result of acute epididymo-orchitis (more than 80% of all cases), much rarer due to testicular inversion and injury. The etiological agent is often E. coli. The disease occurs at any age, especially in immunocompromised patients. Clinical and laboratory picture of testicular abscess has symptomatic nature and consists of local and general signs of purulent inflammation. There are no pathognomonic clinical symptoms. Testicular abscess may occur under the guise of acute inguinal and scrotal area diseases, in a quarter of patients it is characterized by inapparent clinical and laboratory course, simulating testicular tumor or tuberculous orchitis. Diagnostic difficulties are caused by nonspecific clinical and laboratory characteristics and radiation patterns, disease infrequency and a lack of awareness among physicians. Suspicion of testicular abscess arise in ineffectiveness of antibiotic therapy for acute epididymo-orchitis during the first 5-7 days of disease and makes physician to perform necessary X-ray studies. The method of choice for the testicular abscess diagnosis is ultrasound examination. The diagnostic capabilities of other radiation techniques have currently been studying. Ultrasound picture of testicular abscess depending on the disease stage is varying and does not differ from the ultrasound picture of abscess of other localization. The most difficult is differential diagnosis of abscess and testicular tumors. In diagnostically ambiguous cases, ultrasound-guided percutaneous testicle biopsy or exploratory surgery are performed. Choice of treatment method is determined by the disease stage. A variety of conservative and surgical treatment methods of the testicular abscess are applied, such as antibiotic therapy, percutaneous puncture and ultrasound-guided abscess aspiration, abscessotomy and orchiectomy. Prognosis for life is favorable with timely treatment of disease.

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Intratesticular Abscess in a Solitary Testicle: The Case for Testicle Sparing Management

Cited by 5 publications

References 3 publications

Detection and Genomic Characterization of a Morganella morganii Isolate From China That Produces NDM-5

Detection and Genomic Characterization of a Morganella morganii Isolate From China That Produces NDM-5

Organ-preserving treatment of an epididymal abscess in a patient with spinal cord injury

Testicular abscess

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