1
|
Kaur G, Wright K, Verma S, Haynes A, Dufour JM. The Good, the Bad and the Ugly of Testicular Immune Regulation: A Delicate Balance Between Immune Function and Immune Privilege. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1288:21-47. [PMID: 34453730 DOI: 10.1007/978-3-030-77779-1_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The testis is one of several immune privilege sites. These sites are necessary to decrease inflammation and immune responses that could be damaging to the host. For example, inflammation in the brain, eye or placenta could result in loss of cognitive function, vision or rejection of the semi-allogeneic fetus, respectively. In the testis, immune privilege is "good" as it is necessary for protection of the developing auto-immunogenic germ cells. However, there is also a downside or "bad" part of immune privilege, where pathogens and cancers can take advantage of this privilege and persist in the testis as a sanctuary site. Even worse, the "ugly" of privilege is how re-emerging viruses, such as Ebola and Zika viruses, can establish persistence in the testes and be sexually transmitted even months after they have been cleared from the bloodstream. In this review, we will discuss the delicate balance within the testis that provides immune privilege to protect the germ cells while still allowing for immune function to fight off pathogens and tumors.
Collapse
Affiliation(s)
- Gurvinder Kaur
- Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kandis Wright
- Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Saguna Verma
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Allan Haynes
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Jannette M Dufour
- Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| |
Collapse
|
2
|
Gardini G, Comelli A, Pecorelli S, Parolini F, Tomasoni L, Pezzotta R, Fiorentini S, Caruso A, Alberti D, Castelli F. Acute epididymo-orchitis due to Salmonella Typhi in a young man from Bangladesh. Infection 2019; 47:857-860. [PMID: 30771193 DOI: 10.1007/s15010-019-01280-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/09/2019] [Indexed: 10/27/2022]
Abstract
S. typhi infection rarely involves the genitourinary system. We report the first described case of acute epididymo-orchitis due to S. typhi in a 14-year-old boy from Bangladesh. A high index of suspicion should be maintained when evaluating patients coming from endemic countries also in case of unusual sites of infection.
Collapse
Affiliation(s)
- Giulia Gardini
- Department of Infectious and Tropical Diseases, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Agnese Comelli
- Department of Infectious and Tropical Diseases, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.
| | - Silvia Pecorelli
- Department of Pediatric Surgery, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Filippo Parolini
- Department of Pediatric Surgery, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Lina Tomasoni
- Department of Infectious and Tropical Diseases, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Ramona Pezzotta
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Simona Fiorentini
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Arnaldo Caruso
- Department of Microbiology and Virology, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Daniele Alberti
- Department of Pediatric Surgery, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| | - Francesco Castelli
- Department of Infectious and Tropical Diseases, Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, Italy
| |
Collapse
|
3
|
Ryan L, Daly P, Cullen I, Doyle M. Epididymo-orchitis caused by enteric organisms in men > 35 years old: beyond fluoroquinolones. Eur J Clin Microbiol Infect Dis 2018; 37:1001-1008. [PMID: 29450767 DOI: 10.1007/s10096-018-3212-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/08/2018] [Indexed: 11/26/2022]
Abstract
Epididymo-orchitis is a common urological condition in men of all ages, causing a unilateral or bilateral swelling of the epididymis and/or testis. It is frequently caused by sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrheae, as well as common enteric organisms implicated in urinary tract infections. Men over 35 years old may develop epididymo-orchitis associated with enteric organisms, often associated with functional bladder outlet problems such as benign prostatic hyperplasia or urethral stricture disease. Fluoroquinolones, especially ciprofloxacin, have long been the mainstay of treatment for these infections; however, rising resistance to ciprofloxacin in E. coli isolates in Europe and the USA means that there is an unprecedented necessity for alternative antimicrobials with adequate penetration into genital tissues (epididymis and testes) to allow appropriate and comprehensive treatment of epididymo-orchitis in this group of patients.
Collapse
Affiliation(s)
- Laura Ryan
- Department of Clinical Microbiology, University Hospital Waterford, Waterford, Ireland.
| | - Padraig Daly
- Department of Urology, University Hospital Waterford, Waterford, Ireland
| | - Ivor Cullen
- Department of Urology, University Hospital Waterford, Waterford, Ireland
| | - Maeve Doyle
- Department of Clinical Microbiology, University Hospital Waterford, Waterford, Ireland
| |
Collapse
|
4
|
Sharma P, Bhuju A, Tuladhar R, Parry CM, Basnyat B. Tubo-ovarian abscess infected by Salmonella typhi. BMJ Case Rep 2017; 2017:bcr-2017-221213. [PMID: 28827431 PMCID: PMC5623991 DOI: 10.1136/bcr-2017-221213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2017] [Indexed: 11/04/2022] Open
Abstract
We report a case of a tubo-ovarian abscess infected with Salmonella enterica serotype typhi A 19-year-old Nepalese woman presented to a hospital in Kathmandu with lower abdominal pain, constipation, fever and a non-healing, suppurative surgical wound from an emergency caesarian section performed 2 months previously at 37 weeks of pregnancy. She also had an exploratory laparotomy for an appendix perforation with peritonitis at 25 weeks of gestation. Her wound infection did not respond to cloxacillin and she had an exploratory laparotomy, and a tubo-ovarian abscess was found from which S. typhi was isolated. She had a bilateral salpingo-oophorectomy and responded to 14 days of chloramphenicol. A tubo-ovarian abscess is a rare complication of enteric fever.
Collapse
Affiliation(s)
- Paban Sharma
- Department of Obstetrics and Gynecology, Patan Hospital, Kathmandu, Nepal
| | - Abhusani Bhuju
- Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal
| | - Ruhee Tuladhar
- Department of Obstetrics and Gynecology, Patan Hospital, Kathmandu, Nepal
| | - Christopher M Parry
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Buddha Basnyat
- Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal
| |
Collapse
|
5
|
An Unusual Case: SalmonellaUTI and Orchitis in HIV Patient. Case Rep Med 2015; 2015:216720. [PMID: 26257784 PMCID: PMC4516818 DOI: 10.1155/2015/216720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 06/21/2015] [Indexed: 12/02/2022] Open
Abstract
Salmonellosis is a major cause of gastroenteritis in the United States; however, nontyphoidal strains of Salmonella have also been known to cause urinary tract infections, usually transmitted via the fecal-urethral route. This can lead to critical illness in those patients with immune deficiencies, especially HIV, cancer patients, and those with diabetes mellitus. However, the spread of the infection from the urinary tract to involve the testicles and epididymis is very rare. Here, we present the first documented case of an immune-compromised young male with a urinary tract infection with orchitoepididymitis.
Collapse
|
6
|
Chao CT. Concurrent Salmonella mycotic abdominal aneurysm and empyema thoracis: a rare coincidence. Med Princ Pract 2014; 23:482-4. [PMID: 24504129 PMCID: PMC5586906 DOI: 10.1159/000358199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 12/23/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To present a case of Salmonella bacteremia with a rare metastatic focus. CLINICAL PRESENTATION AND INTERVENTION A 61-year-old male presented with a suicide attempt after ingestion of half a bottle of toilet cleaner. He had a medical history of intravenous drug abuse and major depression. Persistent Salmonella enteritidis bacteremia occurred during his hospitalization, and a search for the primary source of infection disclosed a mycotic abdominal aortic aneurysm. A suppurative lesion was also noted over the left pleural space, and Salmonella empyema was confirmed after thoracentesis. He underwent video-assisted thoracoscopic surgery and endovascular repair of the abdominal aortic aneurysm and was placed on long-term antibiotics, without recurrence. CONCLUSION S. enteritidis involvement of the cardiovascular system is a rare coincidence and results in significant morbidity and mortality. In addition, the phenomenon of secondary metastatic infective foci involving the pleural space has an even lower frequency than that of cardiovascular involvement. Therefore, a high index of suspicion and prompt treatment from the treating physicians are strongly recommended.
Collapse
Affiliation(s)
- Chia-Ter Chao
- *Chia-Ter Chao, Renal Division, Department of Internal Medicine, National Taiwan University Hospital Jin-Shan Branch, No. 51, Nan-Shih, Jin-Shan District, New Taipei 20844, Taiwan (ROC), E-Mail
| |
Collapse
|
7
|
Jiménez-Pacheco A, Jiménez-Pacheco A, Ranea-Jimena S, López-Luque A. Abscesos testiculares: abordaje quirúrgico. A propósito de 2 casos. Rev Int Androl 2013. [DOI: 10.1016/j.androl.2012.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
8
|
Celeghini E, Gregory L, Pinheiro E, Piva F, Carneiro P, Parapinski-Santos B, Bianchi M, Benesi F. Orquiepididimite em carneiro por Salmonella enterica sub-diarizonae: primeiro caso na América do Sul. ARQ BRAS MED VET ZOO 2013. [DOI: 10.1590/s0102-09352013000100021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste artigo é relatar um caso de orquiepididimite associado com infecção por Salmonella enterica subespécie diarizonae em carneiro da raça Santa Inês de quatro anos de idade, vasectomizado. Ao exame clínico reprodutivo, o animal mostrou aumento severo do conteúdo escrotal, sendo o testículo direito maior do que o esquerdo e a cauda do epidídimo direita maior do que a esquerda. A consistência testicular, avaliada em escala de 1 a 5, foi 5 para o testículo direito e 2,5 para o esquerdo; o órgão apresentava-se muito sensível ao toque. Na ultrassonografia foram observadas estruturas anecoicas/hipoecoicas circulares na cauda do epidídimo, sugestivas de abscessos; alguns pontos hiperecogênicos no parênquima testicular, sugerindo lesões de calcificação; e todo o testículo direito rodeado por imagem hipoecoica, indicativa de edema. Uma das estruturas da cauda do epidídimo direita foi puncionada, encontrando-se exsudato purulento, o qual foi enviado para exame microbiológico, sendo isolada e identificada Salmonella enterica subespécie diarizonae. O carneiro foi submetido a orquiepididectomia, e o órgão foi caracterizado macroscopicamente por adesões fibrosas entre as camadas escrotais, coexistência de abscessos epididimários e degeneração testicular. A Salmonella enterica subespécie diarizonae deve ser considerada no diagnóstico diferencial de infecção genital em ovinos.
Collapse
|
9
|
Epididymo-orchitis: an unusual manifestation of salmonellosis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2011; 45:318-20. [PMID: 22138654 DOI: 10.1016/j.jmii.2011.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Revised: 04/13/2011] [Accepted: 06/02/2011] [Indexed: 11/20/2022]
Abstract
Salmonellosis continues to be a major public health problem, especially in developing countries. The formation of focal abscesses may occur following either hematogenous or lymphatic spread. There are large number of serious and life-threatening clinical manifestations of Salmonella spp., ranging from osteomyelitis to infective endocarditis and meningitis. However, even though Salmonella epidydimo-orchitis is a relatively rare clinical manifestion, it can present, most often in male babies and adolescent boys, following contact with nontyphoidal Salmonella. Here, we report a case of epididymo-orchitis due to Salmonella Paratyphi A that presented in an otherwise healthy 63-year-old man in order to highlight this organism's unusual clinical presentation. In countries such as India, where Salmonella infections are endemic, a high index of suspicion should be always be maintained and the possibility of a Salmonella infection at an aberrant site where it is hardly expected should not be ruled out.
Collapse
|