Acute mumps orchitis
Introduction
Introduction to acute mumps orchitis Acute mumps orchitis (viralorchitis) caused by mumps virus, mainly transmitted by blood, is a common complication of mumps, can cause softening and atrophy of testes, such as involving both sides can cause male infertility, The epididymis can be involved at the same time during inflammation. In the past, the disease was thought to occur in adults, and the undeveloped testes were not invaded. In recent years, the incidence of orchitis caused by mumps has increased. Adolescents and even 3-year-old children have also reported, and testicular atrophy and infertility and other sequelae. And the incidence of tumors increased. basic knowledge Sickness ratio: 1%-2% Susceptible people: male Mode of infection: non-infectious Complications: male infertility
Cause
Causes of acute mumps orchitis
(1) Causes of the disease
Mumps virus infection is the most common cause of orchitis.
(two) pathogenesis
The testis height is enlarged and blue in the naked eye. When the testis is incised, the testicular tubules cannot be squeezed out due to interstitial reaction and edema. Interstitial edema and vascular enlargement are observed by histology. A large number of lobular granulocytes, lymphocytes Infiltration with macrophages, expansion of fine tubules, inflammatory cells in the lumen, when the orchitis heals, the testicles become smaller, softer, the spermatogonial cells disappear, the interstitial lymphocytes infiltrate, and fibrosis occurs. Glassy change.
Prevention
Acute mumps orchitis prevention
Live attenuated mumps virus vaccine is a powerful preparation for the prevention of mumps and concurrent orchitis. It is generally vaccinated for susceptible children under 1 year old, and can also use 20 ml of mumps hyperimmune globulin. In the incubation period of the disease, the development of the disease can be alleviated. The conventional application of estrogen or adrenal corticosteroid may have the effect of preventing orchitis in children with mumps, but there is still debate.
Complication
Complications of acute mumps orchitis Complications, male infertility
About 30% of patients with orchitis caused by mumps irreversibly destroy sperm, and the testicles are highly atrophied. For example, bilateral orchitis leads to male infertility, but androgen levels are generally normal.
Symptom
Acute mumps testicular inflammation symptoms Common symptoms Parotid swelling swelling testicular pain chills nausea and vomiting on the side of the scrotum gradually...
1. There is a history of mumps, swollen parotid glands, redness and swelling of the parotid glands, and secretions appear.
2. Testicular pain, may be associated with fever, chills, nausea, vomiting and other systemic symptoms, often appear 3 to 4 days after the occurrence of mumps.
3. The scrotum is red and swollen, the testicles are swollen and the tenderness is obvious.
Examine
Examination of acute mumps orchitis
Laboratory tests for white blood cells can be increased, urine analysis is mostly normal, sometimes visible protein or microscopic hematuria, acute pathogenic virus can be found in the urine, in addition, fluorescent antibodies can be used to detect viral antibodies in serum.
Color Doppler B-ultrasound is an effective diagnostic tool that can eliminate testicular and accessory torsion and confirm inflammation of the testis and epididymis.
Diagnosis
Diagnosis and diagnosis of acute mumps orchitis
According to the history of mumps, clinical manifestations and signs, the general diagnosis is not difficult, but if the manifestations of epididymal orchitis, then further urine analysis and urine culture to rule out bacterial infection, serum immunofluorescence antibody test can confirm the diagnosis.
1. Testicular torsion showed sudden scrotal swelling, pain with obvious tenderness, but no history of mumps, lifting scrotal pain did not reduce, but worsened; no fever; color Doppler visible testicular blood perfusion Reduce or disappear.
2. Acute epididymitis may have sudden scrotal swelling, pain accompanied by obvious tenderness, but initially only the epididymis is enlarged, the testicles may be normal or slightly hard; when the epididymal inflammation spreads to the testicles, the boundary between the testis and the epididymis Unclear, there are tenderness.
3. Acute suppurative orchitis can also be characterized by sudden scrotal pain, swelling, but no history of mumps, usually testicular, epididymal enlargement and unclear boundaries, effective treatment with antibiotics.
4. Incarcerated oblique sputum can also be expressed as sudden scrotal pain, swelling, previous history of inguinal hernia, abdominal distension after engrafting, vomiting, physical examination can sputum and scrotum mass and normal testicles .
