Microbiological survey of acute epididymitis.

Hawkins, D. F.; Taylor‐Robinson, David; Thomas, Barbara J.; Harris, J. R. W.

doi:10.1136/sti.62.5.342

Cited by 20 publications

(26 citation statements)

References 4 publications

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“…The leucocyte esterase test, with its Leucocyte esterase test as rapid screen for non-gonococcal urethritis 96% sensitivity, identifies on their first visit almost all patients who need treatment for NGU, thereby preventing delay in treatment and contact tracing and any unwanted sequlae. 26 …”

Section: Discussionmentioning

confidence: 99%

Leucocyte esterase test as rapid screen for non-gonococcal urethritis.

Perera

Jones

Srikantha

et al. 1987

Sexually Transmitted Infections

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SUMMARY The two standard tests for the initial diagnosis of non-gonococcal urethritis (NGU), microscopic examination of gram stained urethral smears and the two glass urine test, have the disadvantage of being insensitive and subjective. The leucocyte esterase test detects enzymes specific to polymorphonuclear leucocytes and can therefore be used as a sensitive indicator of pyuria. This study sought to evaluate its use as a rapid, sensitive, and non-subjective method of screening for NGU.Of the 81 men with urethral symptoms in the study group, 26 had more than 5 polymorphonuclear leucocytes per high power field (x 1000) and all 26 were leucocyte esterase test positive; whereas 55 had fewer than 5 polymorphonuclear leucocytes per high power field, but 29 (53%) of them had a positive leucocyte esterase test result. In addition, 25 patients in the study group yielded Chlamydia trachomatis on culture. Of these 25, 24 (96%) were leucocyte esterase test positive, whereas only 11 (44%) were Gram stain positive.All 40 patients in the control group (without urethral symptoms or signs) were leucocyte esterase test negative.The leucocyte esterase test is thus a rapid, sensitive, and non-subjective screening aid in the diagnosis ofNGU. Patients and methodsWe studied 81 unselected heterosexual men aged 15 to 70 attending the department of genitourinary medi-380 on 1 May 2019 by guest. Protected by copyright.

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Section: Discussionmentioning

confidence: 99%

Leucocyte esterase test as rapid screen for non-gonococcal urethritis.

Perera

Jones

Srikantha

et al. 1987

Sexually Transmitted Infections

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“…The pathogens responsible are Chlamydia trachomatis and common urinary tract pathogens including E . Berger (1979) and Hawkins (1986) correlated age and the occurrence of bacteria and found that Chlamydia trachomatis predominated in men younger than 35 years, while E. coli occurred more often in men over 35 years. The intestine serves as a reservoir from where bacteria enter the sterile urinary tract and reach the epididymis by retrograde spread (Melekos & Asbach, 1987).…”

Section: Introductionmentioning

confidence: 99%

Immuno‐competent cells in the murine epididymis following infection with Escherichiu coli

Nashan¹,

Jantos

Ahlers³

et al. 1993

Int J of Andrology

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Epididymitis was induced by retrograde injection of Escherichia coli into the vas deferens of 28 mice. A group of 28 saline-injected animals served as controls. On Days 1, 3, 7 and 28, groups of seven animals were killed. Bacterial culture was performed. Leucocyte numbers and distribution were determined in epididymides. In infected mice, E. coli were isolated from all epididymides on Days 1 and 3, but only from five of seven epididymides on Days 7 and 28. One week after infection, the total number of macrophages rose from about 10 to 28%. Significantly increased macrophage percentages were also found in animals killed 28 days after infection. A simultaneous increase in MHC class II positive cells was seen on Day 7. A total of 20% of the cells expressed MHC class II in infected epididymides (normal = 6%). A similar increase was found on Day 28 after infection. Most of the macrophages and MHC class II positive cells were located in the interstitium, fewer in the peritubular layer and nearly none in the epithelium. The main increase in these cells occurred in the interstitium and, to a lesser but significant extent, in the peritubular area. T-helper and T-suppressor/cytotoxic lymphocytes reached peak values on Day 28. The increase in T-lymphocytes and simultaneous appearance of plasma cells followed the increase in numbers of macrophages and MHC class II positive cells. They were located mainly in the interstitium. A sequential increase in leucocyte subsets and negative culture results for E. coli were observed on Days 7 and 28 (2/7 on each day). The inflammatory process was restricted to the interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…2 Existing guidelines are based on a clinical consensus that in men under 35 years, epididymo-orchitis is most commonly caused by a sexually transmitted pathogen such as Chlamydia trachomatis or Neisseria gonorrhoeae. [3][4][5][6][7] In older men, the infection is more likely to be due to non-sexually transmitted enteric Gram-Novel organisms, such as Mycoplasma genitalium, which are not included in testing regimes, may be involved in such cases. The data underlying this conventional divide at 35 years may, however, be questioned, as they are based on small studies in selected populations.…”

Section: Introductionmentioning

confidence: 99%

“…The data underlying this conventional divide at 35 years may, however, be questioned, as they are based on small studies in selected populations. [3][4][5][6][7] Guidelines from the US and UK suggest a detailed testing schedule, involving C. trachomatis, N. gonorrhoeae, urethral swabs or firstvoid urine culture, and midstream urinalysis (MSU), followed by antibiotics as indicated by history, with doxycycline for likely C. trachomatis infections, ceftriaxone/ciprofloxacin followed by doxycycline for N. gonorrhoeae infections, and ofloxacin/ciprofloxacin for enteric organisms. 8,10 Effective treatment and management of epididymoorchitis is important for clinical and public health reasons.…”

Section: Introductionmentioning

confidence: 99%

Management of epididymo-orchitis in primary care: results from a large UK primary care database

Nicholson¹,

Rait²,

Murray‐Thomas³

et al. 2010

Br J Gen Pract

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BackgroundEpididymo-orchitis is a common urological presentation in men but recent incidence data are lacking. Guidelines for management recommend detailed investigation and treatment for sexually transmitted pathogens, such as Chlamydia trachomatis. Data from secondary care indicate that these guidelines are poorly followed. It is not known how epididymo-orchitis is managed in UK general practice. AimTo estimate the incidence of cases of epididymoorchitis seen in UK general practice, and to describe their management. Design of studyCohort study. Setting UK general practices contributing to the General Practice Research Database (GPRD). MethodMen, aged 15-60 years, consulting with a first episode of epididymo-orchitis between 30 June 2003 and 30 June 2008 were identified. All records within 28 days either side of the diagnosis date were analysed to describe the management of these cases (including location) and to compare this management with guidelines. ResultsA total of 12 615 patients with a first episode of epididymo-orchitis were identified. The incidence was highest in 2004-2005 (25/10 000) and declined in the later years of the study. Fifty-seven per cent (6943) of patients were managed entirely within general practice. Of these, over 92% received an antibiotic, with ciprofloxacin being the most common one prescribed. Only 18% received a prescription for doxycycline. Most men, including those under 35 years, had no investigation recorded and fewer than 3% had a test for chlamydia. ConclusionThese results indicate low rates of specific testing and treatment for sexually transmitted infections in males who attend general practice with symptoms of epididymo-orchitis. There is a need for further research to understand the pattern of care delivered in general practice.

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Microbiological survey of acute epididymitis.

Cited by 20 publications

References 4 publications

Leucocyte esterase test as rapid screen for non-gonococcal urethritis.

Leucocyte esterase test as rapid screen for non-gonococcal urethritis.

Immuno‐competent cells in the murine epididymis following infection with Escherichiu coli

Management of epididymo-orchitis in primary care: results from a large UK primary care database

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