tetracycline and Epididymitis

To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously.. In this retrospective study, records of all 26 adult patients with brucellosis, who presented with epididymitis or epididymo-orchitis at a tertiary hospital in Riyadh from 1983 to 2000, were reviewed. Positive blood culture or high agglutination titres of > or = 1 : 320 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Among these cases, epididymitis or epididymo-orchitis was diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis.. Epididymo-orchitis occurred in 1.6% of all patients with brucellosis. Most (58%) were 25--44 years old; approximately 77% of the patients presented with acute symptoms of < 2 weeks' duration. All patients complained of swollen painful testicles. Other presenting symptoms included undulant fever (96%), chills (54%) and arthralgia (23%). Four patients had dysuria and one haematuria. Ten patients gave a positive history of ingestion of raw milk and milk products; one patient had laboratory-acquired brucellosis. Six patients had unilateral epididymo-orchitis (two with features of florid presentation); the remaining 20 had only orchitis (bilateral in two, right in 10 and left in eight). Leucocytosis was present in six patients; 25 had initial agglutination titres of > 1 : 320 and the remaining patient had a positive blood culture. All patients received combined therapy with streptomycin for the first 2 weeks (or oral rifampicin for 6 weeks) with doxycycline or tetracycline for 6 weeks. All showed improvement, fever subsided in 2--5 days and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year.. In brucellosis-endemic areas, clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis. A careful history, a meticulous physical examination and a rapid laboratory evaluation help in diagnosis. Clinical and serological data are sufficient for diagnosis. Leucocytosis is not an atypical feature of brucellar epididymo-orchitis and so cannot be used for differentiating it from the nonspecific variety. Conservative management with combination antibiotic therapy is adequate for managing brucellar epididymo-orchitis.

Topics: Adolescent; Adult; Aged; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Fever; Humans; Length of Stay; Male; Middle Aged; Orchitis; Retrospective Studies; Rifampin; Saudi Arabia; Streptomycin; Tetracycline

The role of Chlamydia trachomatis in infections of the male genital tract is reviewed. The organism is an important cause of non-gonococcal urethritis, post-gonococcal urethritis and epididymitis, but does not appear to play a major part in the pathogenesis of chronic abacterial prostatitis or in proctitis in anoreceptive homosexual men.

Topics: Chlamydia Infections; Chlamydia trachomatis; Epididymitis; Genital Diseases, Male; Humans; Male; Tetracycline; Urethritis

Topics: Acute Disease; Adult; Age Factors; Analgesics; Epididymitis; Genital Diseases, Male; Gonorrhea; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Technetium; Testicular Neoplasms; Testis; Tetracycline; Trachoma; Ultrasonography

Nongonococcal urethritis is a venereal disease whose incidence is almost double that of gonorrhea. Despite this, the diagnosis, origin, treatment, and complications of nongonococcal urethritis remain unclear. Although some cases are undoubtedly caused by infection with Chlamydia trachomatis, the origin of many cases is uncertain. Treatment is recommended to shorten symptoms and prevent complications. This review presents the current status of this confusing disease.

Topics: Adolescent; Adult; Epididymitis; Female; Gonorrhea; Humans; Infant; Male; Mycoplasma Infections; Neisseria gonorrhoeae; Pelvic Inflammatory Disease; Pneumonia; Sexually Transmitted Diseases; Tetracycline; Trachoma; Urethritis

Topics: Administration, Oral; Arthritis, Reactive; Candida; Chlamydia; Coitus; Culture Media; Epididymitis; Female; Gonorrhea; Humans; Male; Mycoplasma; Neisseria gonorrhoeae; Prostatitis; Recurrence; Tetracycline; Urethral Stricture; Urethritis; Urine

Topics: Abattoirs; Abscess; Agglutination Tests; Animals; Body Weight; Brucella; Brucella abortus; Brucellosis; Cattle; Chloramphenicol; Epididymitis; Fever; Humans; Illinois; Iowa; Lymphatic Diseases; Male; Occupational Diseases; Pyridazines; Splenomegaly; Streptomycin; Sulfanilamides; Tetracycline

There were 50 patients with acute epididymitis who were evaluated prospectively by history, examination and microbiologic studies, including cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. Escherichia coli was the predominant pathogen isolated from the urine of men more than 35 years old, while Chlamydia trachomatis and Neisseria gonorrhoeae were the predominant pathogens isolated from the urethra of men less than 35 years old. The etiologic role of Escherichia coli and Chlamydia trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine or urethral cultures for these agents. Chlamydia trachomatis epididymitis accounted for two-thirds of idiopathic epididymitis in young men and often was associated with oligospermia. Of 9 female sexual partners of men with Chlamydia trachomatis infection 6 had antibody to Chlamydia trachomatis, of whom 2 had positive cervical cultures for this organism and 2 others had non-gonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with Chlamydia trachomatis epididymitis and should be offered to the female sex partners.

Topics: Adolescent; Adult; Aged; Ampicillin; Cell Count; Epididymitis; Escherichia coli Infections; Female; Gonorrhea; Humans; Lymphogranuloma Venereum; Male; Middle Aged; Physical Examination; Prospective Studies; Pseudomonas Infections; Semen; Sexual Behavior; Tetracycline

An autogenous, multivalent, adjuvanted bacterin for epididymitis was tested in flocks of 700 to 800 Suffolk X white-faced lambs. Long-term feeding of low dosages of antibiotics also was tested in the Suffolk flock. Both methods appeared to reduce the incidence of the disease. The incidence of clinical epididymitis and the number of positive culture results from clinically affected rams were significantly reduced.

Topics: Actinobacillus; Actinobacillus Infections; Animals; Bacterial Vaccines; Epididymitis; Haemophilus; Haemophilus Infections; Male; Sheep; Sheep Diseases; Sulfamethazine; Tetracycline; Time Factors

A series of 40 patients presented with epididymo-orchitis between January 1983 and August 1985. In 14 brucellosis was diagnosed. In 10 of these (72%) both testis and epididymis were involved and 1 had bilateral disease. All patients with brucella epididymo-orchitis were treated with streptomycin and tetracycline and complete resolution occurred in 8 (57%).

Topics: Adolescent; Adult; Aged; Brucellosis; Epididymitis; Humans; Male; Middle Aged; Orchitis; Streptomycin; Tetracycline

Chlamydiae are obligate intracellular parasites, bacteria with a peculiar biology. They belong to the genus Chlamydia which includes two species: C. psittaci and C. trachomatis. A wide range of hosts, including birds, mammals and man can be infected by chlamydiae. The diseases chlamydiae can produce include psittacosis, lymphogranuloma venereum, trachoma, inclusion conjunctivitis, urethritis, cervicitis, pelvic inflammatory disease, and neonatal pneumonia. The diagnosis of chlamydial infection may be made by visualization of the organism in direct smears, isolation of the agent in cell culture, or by demonstrating a significant rise in antibody titer. Chlamydial infection may be treated with tetracycline, erythromycin, or sulfonamides.

Topics: Adult; Arthritis, Reactive; Child; Chlamydia Infections; Conjunctivitis, Inclusion; Epididymitis; Erythromycin; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lymphogranuloma Venereum; Male; Pelvic Inflammatory Disease; Pneumonia; Sexually Transmitted Diseases; Tetracycline; Trachoma; Urethritis; Uterine Cervicitis

Topics: Animals; Biological Assay; Chlamydia Infections; Chlamydia trachomatis; Dogs; Epididymis; Epididymitis; Humans; Male; Staphylococcus aureus; Tetracycline

Topics: Ampicillin; Anti-Bacterial Agents; Child; Child, Preschool; Drug Administration Schedule; Epididymitis; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Neisseria gonorrhoeae; Ophthalmia Neonatorum; Penicillin G Procaine; Penicillinase; Pregnancy; Pregnancy Complications, Infectious; Tetracycline

Fifty patients with acute epididymitis were evaluated prospectively by history, examination, and microbiologic studies, including cultures for aerobes, anaerobes, N. gonorrhoeae, Chlamydia trachomatis, and Ureaplasma urealyticum. E. Coli was the predominant pathogen isolated from the urine of men over 35 years old and C. trachomatis and N. gonnorrheae were the predominant pathogens isolated from the urethra of men under 35. The etiologic role of E. Coli and C. trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine of urethral cultures for these agents. C. trachomatis epididymitis accounted for two thirds of "idiopathic epididymitis" in men, and was often associated with oligozoospermia. Of nine female sexual partners of men with C. trachomatis infection, six had antibody to C. trachomatis, of whom two had positive cervical cultures for this organism, and the others had nongonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with C. trachomatis epididymitis, and should be offered to their female sex partner.

Topics: Adolescent; Adult; Chlamydia trachomatis; Epididymitis; Escherichia coli; Female; Humans; Male; Middle Aged; Neisseria gonorrhoeae; Oligospermia; Tetracycline; Ureaplasma; Urine

These recommendations specify appropriate treatment, including dosage of antibiotics for uncomplicated gonococcal infections in adults, infections with penicillinase-producing Neisseria gonorrhoeae, acute salpingitis, acute epididymitis, disseminated gonococcal infections, and gonococcal infections in pediatric patients (including neonatal infections). Special attention is given to important diagnostic considerations, relation of gonococcal infections to concomitant venereal infections, treatment of sexual partners, follow-up, treatment failures, treatments not recommended, allergic problems in treatment, needs for hospitalization, and prevention of gonococcal ophthalmia. Attention is called to the importance of using no less than the recommended dosages of antibiotics.

Topics: Amoxicillin; Ampicillin; Anti-Bacterial Agents; Child; Drug Administration Schedule; Endocarditis, Bacterial; Endophthalmitis; Epididymitis; Female; Gonorrhea; Hospitalization; Humans; Infant, Newborn; Male; Meningitis; Neisseria gonorrhoeae; Penicillin G Procaine; Penicillinase; Pregnancy; Pregnancy Complications, Infectious; Salpingitis; Spectinomycin; Tetracycline

Topics: Acute Disease; Adult; Amoxicillin; Ampicillin; Child; Drug Administration Schedule; Epididymitis; Female; Gonorrhea; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Ophthalmia Neonatorum; Penicillin G Procaine; Pregnancy; Pregnancy Complications, Infectious; Probenecid; Salpingitis; Tetracycline

Topics: Epididymitis; Humans; Male; Tetracycline

Topics: Adult; Diagnosis, Differential; Drug Combinations; Epididymitis; Gonorrhea; Hernia; Humans; Infant, Newborn; Infrared Rays; Male; Orchitis; Penicillins; Phenylbutazone; Prognosis; Prostatitis; Spermatic Cord Torsion; Sulfamethoxazole; Testicular Neoplasms; Tetracycline; Trimethoprim; Tuberculosis

Topics: Anesthesia, Local; Codeine; Epididymitis; Hematoma; Humans; Lidocaine; Male; Methylprednisolone; Postoperative Complications; Testicular Diseases; Tetracycline; Vasectomy

Topics: Acute Disease; Adult; Aged; Bacteria; Child; Cystitis; Epididymitis; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Penicillin Resistance; Penicillin V; Pyelonephritis; Tetracycline; Urethritis; Urinary Tract Infections

Topics: Acute Disease; Adult; Bacteria; Chloramphenicol; Chlortetracycline; Chronic Disease; Cystitis; Demeclocycline; Epididymitis; Female; Humans; Male; Middle Aged; Penicillin G; Pyelonephritis; Streptomycin; Tablets; Tetracycline; Urinary Tract Infections

Topics: Enterobacter; Epididymitis; Escherichia coli Infections; Fever; Humans; Male; Postoperative Care; Prostatectomy; Proteus Infections; Sulfisoxazole; Tetracycline; Vas Deferens

Topics: Anti-Bacterial Agents; Biomedical Research; Blood; Double-Blind Method; Drug Therapy; Epididymitis; Geriatrics; Humans; Male; Pathology; Placebos; Postoperative Complications; Prostatectomy; Prostatic Hyperplasia; Pyelonephritis; Tetracycline; Urethritis; Urine

Topics: Anti-Bacterial Agents; Deoxyribonuclease I; Epididymitis; Humans; Male; Mumps; Orchitis; Streptodornase and Streptokinase; Streptokinase; Tetracycline