Primary infertility associated with schitosoma mansoni: a case report from the Jos plateau, north central Nigeria

Testicular schistosomiasis caused by Schistosoma mansoni is very rare and more so when associated with primary infertility. A 40 years old man from the Jos Plateau, North Central Nigeria presented with primary infertility after ten years of marriage. Sperm count revealed oligospermia and he also complained of inability to sustain erection. Testicular biopsy revealed several ova of Schistosoma mansoni in the connective tissue of the testes. Cases of infertility in endemic areas especially when there is no supply of potable water should raise suspicion of schistosomiasis among other pathologies and possible hormonal disturbances when the testes are involved.

[Testicular toxoplasmosis: a rare case of a testicular mass]

Toxoplasma gondii is an intracellular protozoan infecting birds and mammals. Acute infection is asymptomatic in immune competent people. For immune deficient patients (acquired immune deficiency syndrome, lymphoma patients or those under steroids to prevent organ transplantation rejection) infection may be lethal. We describe an uncommon case of testicular toxoplasmosis in patient under steroids after organ transplantation with no positive serum test for HIV and/or systemic toxoplasmosis.

The occurrence of strongylid nematodes in the epididymides of wood mice

The recent discovery of a larval nematode in the epididymides of free-living wood mice (Apodemus sylvaticus) suggests a sexual transmission of these parasites. They have been placed within the bursate nematodes (order Strongylida) through 18S rDNA analysis, suggesting that they are undetermined metastrongyloid nematodes. The possibility that these parasites are transmitted sexually opens an intriguing field of research because sexually transmitted metazoan parasites are known to occur mainly in invertebrates, whereas in vertebrates sexually transmitted parasites are usually microparasites such as viruses, bacteria and protozoa.

Coccidioidomycosis of the male reproductive tract

Coccidioides immitis infection of the male reproductive tract is a rare entity that can evade diagnosis and pose a dilemma in management. Initially, patients are often evaluated for malignancy or other infections such as tuberculosis. In the past, surgery was the only management option for C. immitis infection of the male reproductive tract, but azole therapy now provides an adjunct or an alternative. We describe two patients who received azole therapy for C. immitis infection of the male reproductive tract. One received fluconazole for prostatic disease, while one received surgery followed by itraconazole for testicular disease. After 12 months of therapy, both remain asymptomatic and have decreased antibody titers against C. immitis.

Testicular schistosomiasis mimicking tumour

Schistosomiasis or bilharziasis is a disease caused by Schistosoma. When infecting men the most common parasites are Schistosoma mansoni, Schistosoma japonicum and Schistosoma haematobium. The Schistosoma mansoni is the only endemic parasite in Brazil. We present a case of testicular schistosomiasis simulating malignancy. The case was treated successfully by excisional biopsy and praziquantel therapy. A review of the literature is discussed.

The Experimental Model of Hydatidosis in Rabbit Testis

OBJECTIVES

Although no part of the human anatomy is invulnerable to hydatid disease, it has been reported to occur mostly in vital organs such as liver, lungs and brain. Hydatid disease of the urinary tract is uncommon accounting for only 2% of all such cases. Testes are extremely rare sites for echinococcosis. To our knowledge there are only 3 cases of testicular hydatid cyst described. In this animal model, we studied echinococcosis in rabbit testis.

METHODS

We directly infected the unilateral testis of 4 male rabbits with infective protoscolices via intratesticular injection and housed them under pathogen-free conditions for 10 weeks. All rabbits survived during the follow-up period and then, at the 10th week, all testes were removed for histopathologic investigation.

RESULTS

Despite of the direct infection of the rabbit testes with Echinococcus granulosus, there was no demonstrable hydatid cyst after a 10-week period except from some fibrosis in the injection tract of the testicular tissue in 1 case.

CONCLUSION

The testes are extremely rare anatomic locations for echinococcosis infection. The mechanism of this resistance should be another reason apart from blood-testicular barrier. We think that low temperature in the scrotum or different properties of the testicular tissue may be the reasons of this defense mechanism. If this hypothesis clarifies with the further studies, new treatment options may be defined in the medical literature for the hydatid cyst.

Parasitic manifestation of testicular pain

Genital filariasis is common in endemic areas of the world. However, filariasis cannot be eliminated from the differential diagnosis of scrotal swellings, as international travel is more frequent. We report a case in a patient in London, UK.

Testicular sparganosis in a child from Uruguay

A patient 9 years old had a painless tumor in the left testicle. The left testicle measured about 5 cm long and about 3 cm wide and was stony hard in part. From an echographic image, the patient was diagnosed to have a hematoma in the left testicle. The left testicle was surgically removed. From histological observations, burrows were surrounded by numerous eosinophils in the testicle, epididymis and tunica vaginalis. Cross sections of spargana were in the burrows. Severe granulomatous orchitis and epididymitis were around the burrows. This case was the second one of human sparganosis in Uruguay.

Testicular dysfunction in BALB C mice with Schistosoma intercalatum bilharziasis

AIM

To evaluate the effect of Schistosoma intercalatum infestation on the testicular function of mice.

METHODS

Male BALB C mice were infested by immersion of the tail and hind feet into the water with 50 or 100 cercariae of Cameroon strain S. intercalatum. Sixty days later the animals were killed, blood was collected and the testis, epididymis and seminal vesicles were dissected and weighed. The plasma and testicular testosterone were evaluated with radioimmunoassay, the seminal vesicular fructose with colorimetric method, and the histology of testis and cauda epididymis observed under light microscope. The intensity of infestation was estimated in terms of S. intercalatum egg load in the liver.

RESULTS

In infested mice, the testicular weight did not change significantly while the epididymal and seminal vesicular weights were significantly lowered compared to the controls. Furthermore, the fructose levels in the seminal vesicle fluid were significantly (P<0.01) reduced in about 50% of infested mice. S. intercalatum infestation also decreased the plasma and testicular testosterone concentrations. Histological studies indicated that the spermatogenesis, the testicular interstitial tissue and the cauda epididymis were qualitatively normal. Parasite eggs were not found in these organs. The mean seminiferous tubular diameter did not show significant differences between the infested and control mice.

CONCLUSION

S. intercalatum infestation impairs testicular function.

Metabolite mapping of human filarial parasite, Brugia malayi with nuclear magnetic resonance

Metabolite mapping of human filarial parasite, Brugia malayi was carried out in vitro as well as in situ in host Mastomys coucha by 31P nuclear magnetic resonance (NMR) spectroscopy. Detection of parasites by visualizing contrast spots due to pathologic changes was observed by 1H magnetic resonance imaging (MRI). Major metabolites of adult B. malayi observed by 31P-NMR spectroscopy were of sugar phosphates (SP), phosphomonoesters (PME), glycerophosphoryl-ethanolamine (GPE), -choline (GPC), phosphoenolpyruvate (PEP), inorganic phosphate (Pi), nucleoside diphosphosugar and nucleotides-mono, -di and -tri phosphates. PEP and GPC were present in high concentration; PEP being the major energy reservoir and GPC the major phospholipid in this species of filaria. The 31P NMR spectra of testis of mastomys, showed seven major peaks of SP, PME, phosphocreatine (PCr), phosphodiesters (PDE), Pi, and nucleotides di- and tri-phosphates. The 31P-NMR spectra of testis of B. malayi infected animal also consisted of seven major peaks with significant decrease in the SP and PME peak showing changes in the carbohydrate and lipid metabolism of filaria infected testis. Thus, in vivo 31P MRS provided a non-invasive assessment of tissue bioenergetics and phospholipid metabolism.

Ultrasound appearance of schistosomiasis of the testis

Schistosomiasis of the testis is rare and its ultrasound findings have not previously been documented in the English medical literature. This case report describes the ultrasound appearances of a case of schistosomiasis of the testis in a 33-year-old male who had recently travelled to Egypt. The ultrasound findings are those of a solid testicular mass with a heterogeneous echotexture identical to that of most testicular malignancies.

Microsurgical epididymal sperm aspiration with motile trophozoite cells but no spermatozoa

This paper reports on a patient in whom the clinical diagnosis of obstructive azoospermia was made according to clinical observations, i.e. azoospermia, normal andrological examination, normal follicle stimulating hormone and a misleading histopathological report of a testicular biopsy. Microsurgical vasoepididymostomy failed to restore fertility, and as a last resort, microsurgical sperm aspiration was performed. Although flagellated cells were observed in the epididymal aspiration, no spermatozoa were observed and wet preparation of multiple testicular biopsies failed to demonstrate any spermatozoon. This patient was diagnosed to have a non-obstructive azoospermia, resulting from maturation arrest associated with trichomonas infection at the level of the epididymis.

Testicular myxosporidiasis in the flat-backed toad, Bufo maculatus (Amphibia: Bufonidae), from Cameroon, Africa

Macroscopic cysts measuring less than or equal to 860 x 500 microns were found in the testes of a flat-backed toad, Bufo maculatus, collected in Cameroon, West Africa. On histologic examination, the cysts contained numerous spores of a Myxobolus sp. (Myxozoa: Myxobolidae). Spores in fixed tissues measured 9.2 microns long, 8.9 microns wide, and 4.0 microns thick; the range of values for length, width, and thickness were 8.8 to 9.6 microns, 8.6 to 9.4 microns, 3.6 to 4.4 microns, respectively (n = 20). The shape index (length/width) was 1.03, and ranged from 1.00 to 1.09. Pathology was limited to a slight constriction of adjacent seminiferous tubules by the cysts. No host inflammatory response was noted. This myxozoan is distinct from all other members of the genus infecting anurans and is assigned the name Myxobolus bufonis sp. n.

Role of leukocytes and amebic proteinases in experimental rat testicular necrosis produced by Entamoeba histolytica

To investigate the role of amebic proteinases and host leukocytes, we studied amebiasis experimentally in the rat testis. The degree of inflammation and necrosis produced by different strains was correlated with proteinase activity and with zymograms. Intratesticular injection of axenically grown trophozoites of a pathogenic strain (HM-1 of Entamoeba histolytica) produced indistinguishable lesions in normal animals and leukopenic rats (less than 1000 leukocytes/mm3), suggesting that granulocytes do not contribute to the formation of lesions in this model. Testicular lesions produced by five different strains of E. histolytica ranging from highly virulent to almost nonpathogenic were proportional to the proteinase activity of each amebic strain. Inhibition of amebic proteinases in vitro and subsequent injection into the rat testis markedly reduced the inflammatory lesions resulting from highly virulent E. histolytica. The pathogenicity of three other amebae (E. laredo, E. moshkovskii, and E. invadens) was generally proportional to their proteinase activity; however, E. laredo showed high proteinase activity and caused minimal tissue damage. These results suggest that the pathogenic potential of Entamoeba spp. in the rat testis may be related to the type as well as the level of their proteinase activity.

Alveolar echinococcosis with involvement of the ureter and testis

Alveolar echinococcosis is a rare disease of the liver, and occasionally of the lungs and brain, that is endemic across areas of Central Europe, the Soviet Union and Alaska. We describe a case of alveolar echinococcosis with involvement of the ureter and testis overshadowing the liver manifestation. The unusual presentation and nondemonstrable exposure to the organism caused misinterpretation of the histological findings and an initial misdiagnosis of tuberculosis.

Hydatid cyst of testis: a case report

A case of a hydatid cyst of the testis is reported that was misdiagnosed clinically as malignant tumor. Echinococcosis should be considered in the differential diagnosis of testicular masses, especially in endemic countries.

Microfilariae in fine needle aspirates from epididymal lesions

Microfilariae of Wuchereria bancrofti were observed in fine needle aspiration smears from three epididymal nodules, and degenerating microfilariae suggestive of Brugia malayi were found in the smears from a fourth case. The smears in all four cases showed a polymorphonuclear inflammatory cell component as well as epithelioid cell granulomata. While blood eosinophilia was present in all four cases, eosinophilia was present in the aspiration smears in only one case. Microfilariae could be demonstrated in the peripheral blood in only one case.