What is orchitis and how does it affect the testicles. What are the main causes of orchitis in men. How is orchitis diagnosed and treated effectively. What lifestyle changes can help manage orchitis symptoms.

Understanding Orchitis: An Overview of Testicular Inflammation

Orchitis is a condition characterized by inflammation of one or both testicles. This painful condition can have serious implications for male reproductive health if left untreated. While not extremely common, orchitis requires prompt medical attention to prevent potential complications.

The inflammation associated with orchitis can be caused by bacterial or viral infections. In many cases, especially among adolescents and young adults, orchitis develops as a complication of mumps – a viral infection that affects the salivary glands. Understanding the causes, symptoms, and treatment options for orchitis is crucial for early detection and effective management of this condition.

Recognizing the Symptoms of Orchitis

Identifying orchitis early is key to preventing long-term complications. The symptoms of orchitis can range from mild to severe and may include:

• Swelling in one or both testicles
• Pain ranging from mild to severe
• Fever or elevated body temperature
• Nausea and vomiting
• Pain during urination
• Painful ejaculation
• Blood in semen
• Enlarged prostate gland
• Swollen lymph nodes in the groin area

In some cases, patients may also experience pain in the lower abdomen and lower back. It’s important to note that these symptoms can vary in intensity and may not all be present in every case of orchitis.

When to Seek Medical Attention

If you experience any of the following symptoms, it’s crucial to consult a doctor immediately:

• Sudden, severe pain in the testicles
• Swelling or tenderness in the scrotum
• Fever accompanied by testicular pain
• Any unusual changes in the size or texture of the testicles

Early intervention can significantly improve the prognosis and prevent potential complications associated with orchitis.

Unraveling the Causes of Orchitis

Orchitis can be triggered by various factors, with infections being the primary cause. The two main types of orchitis are:

Viral Orchitis

Viral orchitis is often associated with mumps, a childhood disease preventable through vaccination. Approximately 33% of males who contract mumps after puberty develop orchitis. Other viruses that can cause orchitis include:

• Epstein-Barr virus
• Varicella-zoster virus
• Coxsackievirus

Bacterial Orchitis

Bacterial orchitis is typically a result of bacteria spreading from the urinary tract or prostate gland. Common bacterial causes include:

• E. coli
• Staphylococcus
• Streptococcus
• Sexually transmitted infections like chlamydia and gonorrhea

Understanding the underlying cause of orchitis is crucial for determining the most effective treatment approach.

Risk Factors for Developing Orchitis

Several factors can increase an individual’s risk of developing orchitis:

• Urinary tract infections
• Recent genital or urinary tract surgery
• Engaging in unprotected sexual intercourse
• Not being vaccinated against mumps
• Having a history of prostate infections
• Using a urinary catheter for an extended period

Being aware of these risk factors can help individuals take preventive measures and seek timely medical attention if symptoms arise.

Diagnosing Orchitis: Medical Procedures and Tests

Accurate diagnosis of orchitis is essential for effective treatment. Doctors typically use a combination of methods to diagnose this condition:

Physical Examination

A thorough physical examination of the testicles, scrotum, and abdomen is usually the first step in diagnosing orchitis. The doctor will check for swelling, tenderness, and any unusual lumps or masses.

Medical History Assessment

The doctor will inquire about your symptoms, their duration, and any recent illnesses or injuries. Information about sexual history and urinary tract problems is also relevant.

Diagnostic Tests

Several tests may be conducted to confirm the diagnosis and identify the underlying cause:

• Urine tests to check for bacterial infections
• Blood tests to detect signs of infection and inflammation
• Ultrasound of the scrotum to visualize the testicles and surrounding structures
• STI screening if a sexually transmitted infection is suspected

In some cases, additional tests like CT scans or MRI may be recommended to rule out other conditions or complications.

Treatment Approaches for Orchitis

The treatment for orchitis depends on its underlying cause and severity. Here are the main approaches used to manage this condition:

Antibiotics for Bacterial Orchitis

If the orchitis is caused by a bacterial infection, antibiotics are the primary treatment. The course typically lasts 10-14 days, and it’s crucial to complete the entire prescribed regimen even if symptoms improve earlier.

Supportive Care for Viral Orchitis

For viral orchitis, treatment focuses on managing symptoms and supporting the body’s natural healing process. This may include:

• Rest and elevation of the scrotum
• Over-the-counter pain relievers like ibuprofen or acetaminophen
• Application of cold packs to reduce swelling and discomfort

Pain Management

Regardless of the cause, pain management is a crucial aspect of orchitis treatment. This may involve prescription pain medications in severe cases or over-the-counter options for milder pain.

Treating Underlying Conditions

If orchitis is secondary to another condition, such as a urinary tract infection or STI, treating the primary condition is essential for resolving orchitis.

It’s important to note that while most cases of orchitis resolve with proper treatment, some patients may experience long-term complications such as testicular atrophy or fertility issues. Regular follow-ups with a healthcare provider are crucial to monitor recovery and address any potential long-term effects.

Lifestyle and Home Remedies for Managing Orchitis

In addition to medical treatments, certain lifestyle changes and home remedies can help manage the symptoms of orchitis and support recovery:

• Rest and avoid strenuous activities: Give your body time to heal by getting adequate rest and avoiding activities that may exacerbate pain or swelling.
• Apply cold compresses: Using cold packs on the affected area can help reduce swelling and alleviate pain. Apply for 15-20 minutes at a time, several times a day.
• Wear supportive underwear: Wearing athletic supporters or snug underwear can help relieve pressure on the testicles and reduce discomfort.
• Stay hydrated: Drinking plenty of water can help flush out bacteria if the orchitis is due to a urinary tract infection.
• Avoid sexual activity: Abstain from sexual activity until the infection has cleared and symptoms have resolved.
• Practice good hygiene: Maintain proper genital hygiene to prevent the spread of infection.

While these measures can provide relief, they should be used in conjunction with medical treatment prescribed by a healthcare professional.

Long-Term Outlook and Potential Complications of Orchitis

Understanding the potential long-term effects of orchitis is crucial for patients and healthcare providers alike. While many men recover from orchitis without permanent issues, some may face long-term complications:

Fertility Issues

One of the most significant concerns associated with orchitis is its potential impact on fertility. In severe cases or when left untreated, orchitis can lead to:

• Reduced sperm production
• Decreased sperm motility
• Testicular atrophy (shrinkage of the testicles)

These effects can potentially result in infertility or reduced fertility. However, it’s important to note that many men who have had orchitis are still able to father children.

Chronic Pain

Some individuals may experience persistent pain in the testicles even after the acute infection has resolved. This chronic pain can affect quality of life and may require ongoing management.

Recurrent Infections

In some cases, particularly with bacterial orchitis, there’s a risk of recurrent infections. This underscores the importance of completing the full course of antibiotics and following up with healthcare providers as recommended.

Testicular Abscess

Although rare, a severe case of bacterial orchitis can lead to the formation of an abscess within the testicle. This complication may require surgical intervention.

Emotional and Psychological Impact

The experience of orchitis and concerns about its potential impact on fertility can have psychological effects. Some men may experience anxiety or depression related to their condition.

Regular follow-ups with healthcare providers are essential to monitor for these potential complications and address them promptly if they arise. For men concerned about fertility, consultation with a fertility specialist may be recommended.

Preventing Orchitis: Proactive Measures for Testicular Health

While not all cases of orchitis are preventable, there are several steps individuals can take to reduce their risk:

Vaccination

Ensuring up-to-date vaccinations, particularly against mumps, is crucial in preventing viral orchitis. The MMR (Measles, Mumps, Rubella) vaccine is typically administered in childhood, with a booster shot recommended for adults in certain situations.

Safe Sexual Practices

Practicing safe sex by using condoms and limiting sexual partners can help prevent sexually transmitted infections that may lead to orchitis.

Urinary Tract Health

Maintaining good urinary tract health can prevent bacterial infections that may lead to orchitis. This includes:

• Staying hydrated
• Urinating regularly and completely emptying the bladder
• Practicing good genital hygiene

Prompt Treatment of Infections

Seeking prompt treatment for any urinary tract or prostate infections can prevent the spread of bacteria to the testicles.

Regular Health Check-ups

Regular check-ups with a healthcare provider can help identify and address any potential risk factors for orchitis.

Self-Examination

Regular self-examination of the testicles can help in early detection of any abnormalities or changes that may indicate orchitis or other testicular conditions.

By implementing these preventive measures, individuals can significantly reduce their risk of developing orchitis and maintain optimal testicular health.

Orchitis: ऑर्काइटिस क्या है? क्या है इसका इलाज?

के द्वारा मेडिकली रिव्यूड डॉ. प्रणाली पाटील · फार्मेसी · Hello Swasthya

Bhawana Sharma द्वारा लिखित · अपडेटेड 20/05/2021

• मूल बातों को जानें
• लक्षण
• कारण
• खतरों के कारण
• जांच और इलाज
• जीवन शैली और घरेलू उपाय

मूल बातों को जानें

ऑर्काइटिस (Orchitis) क्या होता है?

ऑर्काइटिस अंडकोष में होने वाली सूजन है। यह बैक्टीरिया (Bacteria) या वायरस (Virus) के कारण हो सकता है। दोनों अंडकोष एक ही समय में ऑर्काइटिस (Orchitis) से प्रभावित हो सकते हैं। हालांकि इसके लक्षण आमतौर पर सिर्फ एक अंडकोष में दिखाई देते हैं। इस तरह की सूजन अक्सर मम्प्स वायरस (Mumps virus) से होती है। दरअसल मम्प्स एक ऐसी बीमारी है, जो जीनस रुबेला वायरस (Genus Rubella Virus) के कारण होती है। एक व्यक्ति से दूसरे व्यक्ति के संपर्क में आने से यह इंफेक्शन फैलता है।)

और पढ़ें: Mumps: मम्प्स या गलसुआ क्या है? जानें इसके कारण , लक्षण और उपाय

कितना आम है ऑर्काइटिस? (Orchitis is common?)

यह कोई आम बीमारी नहीं है। इस बीमारी के घातक परिणाम हो सकते हैं। इसके बारे में ज्यादा जानकारी के लिए डॉक्टर से संपर्क करें। ध्यान रखें ऑर्काइटिस (Orchitis) की समस्या को इग्नोर ना करें।

और पढ़ें: हाथ को देखकर पता करें बीमारी, दिखें ये बदलाव तो तुरंत जाएं डॉक्टर के पास

लक्षण

 ऑर्काइटिस के सामान्य लक्षण क्या हैं? (Symptoms of Orchitis) 

ऑर्काइटिस (Orchitis) के सामान्य लक्षण हैं:

• एक या दोनों अंडकोष में सूजन आना।
• हल्के से लेकर गंभीर दर्द (Pain) महसूस होना।
• बुखार (Fever) आना या शरीर का तापमान बढ़ना।
• मतली और उल्टी होना।
• टॉयलेट के दौरान दर्द महसूस होना।
• दर्दनाक स्खलन होना।
• वीर्य में खून आना।
• प्रोस्टेट ग्लैंड (Prostate gland) का बढ़ना।
• ग्रोइन में सूजन लिम्फ नोड्स होना।
• ऐसे में कभी-कभी कमर और पेट के निचले हिस्से में दर्द की शिकायत भी हो सकती है।

और पढ़ें: जानिए जेनाइटल स्किन कंडिशन (Genital skin conditions) से जुड़ी बीमारियों एवं इंफेक्शन की पूरी जानकारी

डॉक्टर को कब दिखाना चाहिए?

निम्नलिखित स्थितियों में डॉक्टर से कंसल्टेशन है जरूरी-

और पढ़ें: अगर दिखाई दे रहे हैं ये लक्षण तो हायपोगोनाडिज्म (Hypogonadism) की हो सकती है आशंका

कारण

 ऑर्काइटिस के कारण क्या हैं? (Cause of Orchitis)

ऑर्काइटिस (Orchitis) के निम्नलिखित कारण हो सकते हैं। जैसे:

•  वायरस (Virus) या बैक्टीरिया (Bacteria) ऑर्काइटिस (Orchitis) का कारण बन सकता है।
• अंडकोष में गांठ की वजह से भी ये समस्या हो सकती है।
•  मम्प्स एक बचपन में होने वाली बीमारी है। इससे बचने के लिए टीकाकरण (Vaccination) कराया जाता है।
•  33 प्रतिशत पुरुष जो किशोरावस्था में मम्प्स से पीड़ित होते हैं,  उन्हें आगे चलकर ऑर्काइटिस हो जाता है।
•  पुरुषों में यह बीमारी बैक्टीरिया के इंफेक्शन (Bacterial infection) से भी होती है।

और पढ़ें: पेनिस में होने वाली सूजन, कहीं न बन जाए आपके लिए बड़ी समस्या! ध्यान रखें इन बातों का

खतरों के कारण

क्या चीजें हैं जो ऑर्काइटिस (Orchitis) की संभावना को बढ़ा सकती हैं?

ऑर्काइटिस के कई जोखिम कारक हैं, जैसे:

• यूरिन के रास्ते में संक्रमण
• सर्जरी करवाना जिसमें जननांग या मूत्र मार्ग शामिल है
• बिना कंडोम के सेक्स 

और पढ़ें: टेस्टिक्युलर कैंसर से बचा सकता है ये सेल्फ एग्जाम, ये है स्टेप बाय स्टेप करने का तरीका

ऑर्काइटिस (Orchitis) की दीर्घकालिक दृष्टिकोण क्या है?

ऑर्काइटिस की समस्या से पीड़ित ज्यादातर पुरुष बिना किसी स्थायी प्रभाव के ठीक भी हो जाते हैं। ऑर्काइटिस का इलाज अगर वक्त पर ना करवाया जाए, तो इंफर्टिलिटी की भी समस्या हो सकती है। इसके अलावा-

• एपिडीडिमिस की पुरानी सूजन।
• अंडकोश के भीतर एक फोड़ा, छाला या दाने होना।
• अंडकोष में सिकुड़न आना।
• वृषण ऊतकों का नष्ट होना।

और पढ़ें: पीनस पेन के बड़े कारण क्या हो सकते हैं? दर्द के इन कारणों को जरूर समझिए

जांच और इलाज

 ऑर्काइटिस का परीक्षण कैसे किया जा सकता है? (Diagnosis of Orchitis)

और पढ़ें:  पुरुषों को नहीं इग्नोर करने चाहिए हेल्थ इशू, वरना हो सकती हैं खतरनाक बीमारियां

ऑर्काइटिस का इलाज कैसे करें? (Treatment for Orchitis)

और पढ़ें :इरेक्टाइल डिसफंक्शन का इलाज नहीं करवाने पर 28% महिलाएं चाहतीं है पार्टनर से अलग होना

जीवन शैली और घरेलू उपाय

निम्नलिखित जीवनशैली और घरेलू उपचार आपको ऑर्काइटिस (Orchitis) से निपटने में

मदद कर सकते हैं:

• बिस्तर में आराम करें।
• अपने अंडकोष पर कोल्ड पैक लगाएं।
• भारी वस्तुओं को उठाने से बचें।
• इसके अलावा यदि आपके कोई प्रश्न हैं, तो बेहतर समाधान के लिए कृपया चिकित्सक से परामर्श करें।

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और पढ़ें : पुरुषों के मानसिक स्वास्थ्य को प्रभावित करने वाले कारणों के बारे में जान लें, ताकि देखभाल करना हो जाए आसान

नोट: वायरल ऑर्काइटिस (Orchitis) के इलाज में वक्त लग सकता है, लेकिन धीर-धीरे यह तकलीफ दूर हो जाएगी। हालांकि इस दौरान आप लक्षणों को भी समझते रहें और महसूस कर रहे बदलाओं को डॉक्टर के साथ शेयर करें। दर्द निवारक लेना, आइस पैक लगाना और जब संभव हो तो अंडकोष को ऊंचा करना आपको अधिक आरामदायक बना सकता है।

अगर आप ऑर्काइटिस (Orchitis) या ऑर्काइटिस से जुड़े किसी तरह के कोई सवाल का जवाब जानना चाहते हैं, तो विशेषज्ञों से समझना बेहतर होगा। वहीं अगर आप ऑर्काइटिस से जुड़ी किसी भी समस्या से पीड़ित हैं, तो परेशानी को इग्नोर ना करें और डॉक्टर से कंसल्टेशन जल्द से जल्द करें।

डिस्क्लेमर

हैलो हेल्थ ग्रुप हेल्थ सलाह, निदान और इलाज इत्यादि सेवाएं नहीं देता।

Orchitis/https://radiopaedia. org/articles/orchitis/Accessed on 20/05/2021

Orchitis/https://www.mountsinai.org/health-library/diseases-conditions/orchitis/Accessed on 20/05/2021

Orchitis/https://www.winchesterhospital.org/health-library/article?id=948960/Accessed on 20/05/2021

Orchitis/https://www.ncbi.nlm.nih.gov/books/NBK553165/#:~:text=Orchitis%20is%20defined%20as%20the,male%20sex%20hormones%20and%20sperm./Accessed on 20/05/2021

Mumps orchitis/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1633545/Accessed on 20/05/2021

Orchitis. https://www.mayoclinic.org/diseases-conditions/orchitis/basics/definition/con-20032815. Accessed November 24, 2017.

Orchitis. https://medlineplus.gov/ency/article/001280.htm   Accessed November 24, 2017.

Orchitis. https://www.nchmd.org/education/mayo-health-library/details/CON-20032815 Accessed November 24, 2017.

Current Version

20/05/2021

Bhawana Sharma द्वारा लिखित

के द्वारा मेडिकली रिव्यूड डॉ. प्रणाली पाटील

Updated by: Nidhi Sinha

Marburg virus disease

Two large outbreaks that occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, in 1967, led to the initial recognition of the disease. The outbreak was associated with laboratory work using African green monkeys (Cercopithecus aethiops) imported from Uganda. Subsequently, outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa (in a person with recent travel history to Zimbabwe) and Uganda. In 2008, two independent cases were reported in travellers who had visited a cave inhabited by Rousettus bat colonies in Uganda.

Transmission

Initially, human MVD infection results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies.

Marburg spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e. g. bedding, clothing) contaminated with these fluids.

Health-care workers have frequently been infected while treating patients with suspected or confirmed MVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Transmission via contaminated injection equipment or through needle-stick injuries is associated with more severe disease, rapid deterioration, and, possibly, a higher fatality rate.

Burial ceremonies that involve direct contact with the body of the deceased can also contribute in the transmission of Marburg.

People remain infectious as long as their blood contains the virus.

Symptoms of Marburg virus disease

The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days.

Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Diarrhoea can persist for a week. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy. In the 1967 European outbreak, non-itchy rash was a feature noted in most patients between 2 and 7 days after onset of symptoms.

Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. Fresh blood in vomitus and faeces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. During the severe phase of illness, patients have sustained high fevers. Involvement of the central nervous system can result in confusion, irritability, and aggression. Orchitis (inflammation of one or both testicles) has been reported occasionally in the late phase of disease (15 days).

In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.

 

Diagnosis

It can be difficult to clinically distinguish MVD from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers. Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods:

• antibody-capture enzyme-linked immunosorbent assay (ELISA)
• antigen-capture detection tests
• serum neutralization test
• reverse transcriptase polymerase chain reaction (RT-PCR) assay
• electron microscopy
• virus isolation by cell culture.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

Treatment and vaccines

Currently there are no vaccines or antiviral treatments approved for MVD. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival.

There are monoclonal antibodies (mAbs) under development and antivirals e.g. Remdesivir and Favipiravir that have been used in clinical studies for Ebola Virus Disease (EVD) that could also be tested for MVD or used under compassionate use/expanded access.

In May 2020, the EMA granted a marketing authorisation to Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo). against EVD . The Mvabea contains a virus known as Vaccinia Ankara Bavarian Nordic (MVA) which has been modified to produce 4 proteins from Zaire ebolavirus and three other viruses of the same group (filoviridae). The vaccine could potentially protect against MVD, but its efficacy has not been proven in clinical trials.

Marburg virus in animals

Rousettus aegyptiacus bats are considered natural hosts for Marburg virus. There is no apparent disease in the fruit bats. As a result, the geographic distribution of Marburg virus may overlap with the range of Rousettus bats.

African green monkeys (Cercopithecus aethiops) imported from Uganda were the source of infection for humans during the first Marburg outbreak.

Experimental inoculations in pigs with different Ebola viruses have been reported and show that pigs are susceptible to filovirus infection and shed the virus. Therefore, pigs should be considered as a potential amplifier host during MVD outbreaks. Although no other domestic animals have yet been confirmed as having an association with filovirus outbreaks, as a precautionary measure they should be considered as potential amplifier hosts until proven otherwise.

Precautionary measures are needed in pig farms in Africa to avoid pigs becoming infected through contact with fruit bats. Such infection could potentially amplify the virus and cause or contribute to MVD outbreaks.

Prevention and control

Good outbreak control relies on using a range of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe and dignified burials, and social mobilization. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Marburg infection and protective measures that individuals can take is an effective way to reduce human transmission.

Risk reduction messaging should focus on several factors:

• Reducing the risk of bat-to-human transmission arising from prolonged exposure to mines or caves inhabited by fruit bat colonies. During work or research activities or tourist visits in mines or caves inhabited by fruit\r\n bat colonies, people should wear gloves and other appropriate protective clothing (including masks). During outbreaks all animal products (blood and meat) should be thoroughly cooked before consumption.
• Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their body fluids. Close physical contact with Marburg patients should be\r\n avoided. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing should be performed after visiting sick relatives in hospital, as well as after taking care\r\n of ill patients at home.
• Communities affected by Marburg should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures.
• Outbreak containment measures include prompt, safe and dignified burial of the deceased, identifying people who may have been in contact with someone infected with Marburg and monitoring their health for 21 days, separating the healthy\r\n from the sick to prevent further spread and providing care to confirmed patient and maintaining good hygiene and a clean environment need to be observed.
• Reducing the risk of possible sexual transmission. Based on further analysis of ongoing research, WHO recommends that male survivors of Marburg virus disease practice safer sex and hygiene for 12 months from onset of symptoms\r\n or until their semen twice tests negative for Marburg virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose\r\n blood has been tested negative for Marburg virus.

Controlling infection in healthcare settings

Healthcare workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe and dignified burial practices.

Healthcare workers caring for patients with suspected or confirmed Marburg virus should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with MVD, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Marburg infection should be handled by trained staff and processed in suitably equipped laboratories.

Marburg viral persistence in in people recovering from Marburg virus disease

Marburg virus is known to persist in immune-privileged sites in some people who have recovered from Marburg virus disease. These sites include the testicles and the inside of the eye.

• In women who have been infected while pregnant, the virus persists in the placenta, amniotic fluid and foetus.

• In women who have been infected while breastfeeding, the virus may persist in breast milk.

Relapse-symptomatic illness in the absence of re-infection in someone who has recovered from MVD is a rare event, but has been documented. Reasons for this phenomenon are not yet fully understood.

Marburg virus transmission via infected semen has been documented up to seven weeks after clinical recovery. More surveillance data and research are needed on the risks of sexual transmission, and particularly on the prevalence of viable and transmissible virus in semen over time. In the interim, and based on present evidence, WHO recommends that:

• Male Marburg survivors should be enrolled in semen testing programmes when discharged (starting with counselling) and offered semen testing when mentally and physically ready, within three months of disease onset. Semen testing should be offered upon obtention of two consecutive negative test results.  

• All Marburg survivors and their sexual partners should receive counselling to ensure safer sexual practices until their semen has twice tested negative for Marburg virus.

• Survivors should be provided with condoms.

• Marburg survivors and their sexual partners should either:

• abstain from all sexual practices, or

• observe safer sexual practices through correct and consistent condom use until their semen has twice tested undetected (negative) for Marburg virus.

• Having tested undetected (negative), survivors can safely resume normal sexual practices with minimized risk of Marburg virus transmission.

• Male survivors of Marburg virus disease should practice safer sexual practices and hygiene for 12 months from onset of symptoms or until their semen twice tests undetected (negative) for Marburg virus.

• Until such time as their semen has twice tested undetected (negative) for Marburg, survivors should practice good hand and personal hygiene by immediately and thoroughly washing with soap and water after any physical contact with semen, including after masturbation. During this period used condoms should be handled safely, and safely disposed of, so as to prevent contact with seminal fluids.

• All survivors, their partners and families should be shown respect, dignity and compassion.

 

WHO response

WHO aims to prevent Marburg outbreaks by maintaining surveillance for Marburg virus disease and supporting at-risk countries to develop preparedness plans. The following document provides overall guidance for control of Ebola and Marburg virus outbreaks:

• Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation

When an outbreak is detected WHO responds by supporting surveillance, community engagement, case management, laboratory services, contact tracing, infection control, logistical support and training and assistance with safe burial practices.

WHO has developed detailed advice on Marburg infection prevention and control:

• Infection prevention and control guidance for care of patients with suspected or confirmed Filovirus haemorrhagic fever in health-care settings, with focus on Ebola

Table: Chronology of major Marburg virus disease outbreaks

Year	Country	Cases	Deaths	Case fatality Rate
2017	Uganda	3	3	100%
2014	Uganda	1	1	100%
2012	Uganda	15	4	27%
2008	Netherland (ex-Uganda)	1	1	100%
2008	United States of America (ex-Uganda)	1	0	0%
2007	Uganda	4	2	50%
2005	Angola	374	329	88%
1998 to 2000	Democratic Republic of the Congo	154	128	83%
1987	Kenya	1	1	100%
1980	Kenya	2	1	50%
1975	South Africa	3	1	33%
1967	Yugoslavia	2	0	0%
1967	Germany	29	7	24%

 

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causes, symptoms, diagnosis and treatment

• INVITRO
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• Directory of Diseases
• Orchitis

Testicular inflammation

Epidymitis

Mumps

Urethritis

Prostatitis

STI

Testicular injury

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01 November

Orchitis: causes, symptoms, diagnosis and treatment.

Definition

Orchitis is an inflammatory process in the tissue of one or both testicles caused by viruses, bacteria or trauma. The peak incidence occurs at the age of 15-38 years, and boys who have not reached puberty are the least affected.

Causes of orchitis

Doctors agree that in most cases orchitis develops as a complication of inflammatory diseases of the genitourinary system (urethritis, prostatitis, epididymitis), when the bacterial microflora enters the tissue of the testicles with blood flow.

The next most common cause of orchitis is viral infection (parotitis, influenza, scarlet fever, pneumonia, chicken pox, brucellosis, etc.). Viral infection often provokes orchitis in children.

The greatest number of cases of the development of the inflammatory process in the testicular tissue is observed after mumps (mumps), and the smallest – after the Coxsackie virus, cytomegalovirus, adenoviruses.

Bacterial orchitis in children can be the result of congenital anomalies, for example, ectopia of the ureteral orifice, ectopia of the vas deferens, diverticulum, etc. , as well as functional disorders (for example, spasm of the external urethral sphincter).

Sexually transmitted infections (gonococci, chlamydia, mycoplasmas, Trichomonas) can cause the development of orchitis in men.

In rare cases, mycobacterium tuberculosis, testicular injury, as well as bladder catheterization and surgical interventions such as lithotripsy, urethrocystoscopy, etc., lead to orchitis, when the integrity of the mucosa is violated.

In addition to the main causes of orchitis, there are a number of factors that increase the risk of the disease. These include diabetes mellitus, HIV, radiation, hormonal and chemotherapy.

Taking into account a fairly wide range of causes that can cause an inflammatory process in the testicular tissue, we can talk about a significant number of pathogens: staphylococcus, chlamydia, mycoplasma, Pseudomonas aeruginosa, Candida fungi, ureaplasma.

Disease classification

1. Specific infectious orchitis:

• gonorrheal,
• Trichomonas,
• tuberculosis.

2. Non-specific infectious orchitis:

• bacterial,
• viral,
• mycoplasma,
• chlamydial.

3. Necrotizing-infectious orchitis:

• torsion and necrotization of testicular appendages,
• incomplete testicular torsion,

4. Granulomatous orchitis caused by seminal granuloma.

5. Traumatic orchitis.

6. Congestive orchitis.

Along the course, acute orchitis (serous and purulent), chronic orchitis and recurrent orchitis are distinguished.

Symptoms of orchitis

Acute orchitis

Acute orchitis manifests as testicular pain that may radiate to the groin, lower back, and perineum. The scrotum on the side of the pathological testicle first increases due to edema, and then becomes hyperemic and hot. In addition, nonspecific symptoms of the inflammatory process are observed: weakness, fever up to 39°C, loss of appetite.

Chronic orchitis

Chronic orchitis develops as a complication of acute orchitis, chronic prostatitis, urethritis and vesiculitis. Chronic orchitis can make itself felt with a slight soreness of the testicle on palpation. With an exacerbation, the patient feels pain while walking, in addition, the body temperature can rise to subfebrile values.

Orchitis diagnostics

Laboratory tests:

• complete blood count;

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

Up to 1 business day

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RUB 810

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• urinalysis;

General urinalysis (Urine analysis with sediment microscopy)

Method of determination

Determination of physical and chemical parameters is carried out on an automatic analyzer using the “dry chemistry” method.

Hardware microscope…

Up to 1 business day

Available with house call

410 RUB

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• coagulogram;

Extended hemostasiogram (coagulogram)

Synonyms: Hemostasiogram.
Coagulation studies (coagulation profile, coag panel, coagulogram).
Brief description of the study “Hemostasiogram (coagulogram) extended”
…

Up to 1 business day

Available with house call

4 455 RUB

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• Mumps orchitis is confirmed by detection of IgM class antibodies and IgG class antibodies to mumps virus.

Anti-mumps IgM

Marker of acute infection with mumps virus.
Mumps (“mumps”) is a highly contagious systemic viral infection that usually occurs with flare…

Up to 5 business days

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RUB 935

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Anti-mumps IgG

Marker of immune response to current or past infection or effective vaccination.
Mumps (mumps) is a highly contagious systemic virus…

Up to 3 business days

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RUB 935

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Instrumental studies:

• Ultrasound of the urinary system and scrotum allows you to assess the condition of the affected testicle, exclude other pathologies (tumor, abscess, torsion).

Urinary Ultrasound, Complete (kidneys, ureters, bladder) – by lead specialist)

3 490 RUB

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Scrotal Ultrasound – by lead specialist

RUB 2,690

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Ultrasound of the scrotum

Ultrasound scanning of the tissues of the structural elements of the scrotum to search for pathologies of this organ.

RUB 2,090

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If necessary, the doctor may prescribe additional tests:

• to exclude sexually transmitted infections, patients who are sexually active are prescribed an analysis for gonococci and chlamydia.

Detection of STI pathogens (7+KVM*), scraping of epithelial cells of the urogenital tract

Determination of the DNA of microorganisms that cause the most common sexually transmitted infections (STIs) in the vaginal, cervical and urethral nipples. ..

Up to 1 business day

Available with house call

RUB 3,185

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• in doubtful cases (if a tumor process is suspected), magnetic resonance imaging of the scrotum and pelvic organs is performed.

MRI of the scrotum

Scanning of the scrotum to look for pathological changes, including traumatic, inflammatory and oncological etiology.

RUB 6,190

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MRI of the pelvic organs

An examination that allows obtaining data on the state of the pelvic organs, revealing pathological changes and tumors.

RUB 6,490

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Differential diagnosis is carried out with nonspecific epididymitis, testicular tuberculosis, testicular tumor.

Which doctors to contact

Treats orchitis
urologist. If a testicular neoplasm is suspected, a consultation is required
oncologist.

Treatment of orchitis

Treatment of acute orchitis is usually carried out at home and does not require hospitalization of the patient. Therapy is aimed primarily at the disease that caused the inflammatory process in the testicle. The presence of a bacterial infection implies the use of antibiotics. In addition, vitamins and drugs that support immunity can be prescribed. Physiotherapy procedures are very effective, but they are used only after the acute process subsides.

If orchitis is of a viral nature, then antibiotics are not the drugs of choice and their use is impractical. The patient is offered symptomatic therapy: painkillers and antipyretics.

When an abscess is detected, it is required to open it in a hospital setting.

Chronic orchitis is treated with long-term antibiotic therapy and physical therapy to help reduce the risk of recurrence.

Inflammation of the testis caused by a sexually transmitted infection involves the treatment of not only the patient, but also his sexual partner. Broad-spectrum antibiotics are prescribed for a course of up to 4 weeks. Non-steroidal anti-inflammatory drugs are used to relieve pain and inflammation.

Complications

Severe orchitis may be complicated by testicular abscess and sepsis.

Violation of spermatogenesis and infertility develop after bilateral orchitis in the absence of timely and correct treatment.

Prevention of orchitis

Doctors consider the timely treatment of acute and chronic diseases of the genitourinary system to be the basis for the prevention of orchitis. In addition, injuries to the perineum and hypothermia should be avoided.
It must be remembered that orchitis can become a complication after sexually transmitted infections, so it is important to use barrier contraceptives and avoid casual sex.

For boys, in the absence of contraindications, it is especially important to vaccinate against mumps on time.

Sources:

1. Akkaliev M.N. Acute orchiepididymitis: current aspects of etiology, diagnosis and treatment. Literature review // Science and health care. – 2017. – 17 p.
2. Yarovoy S. Khromov R. Kareva E. Post-traumatic orchitis: pathogenesis, treatment tactics, prognosis // Vrach. – 2018; 29(10): 3-8.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Genital infections: orchitis | Emergency live

Children are most often affected by this disease: 80% of patients are under 10 years of age.

However, this infection can also affect adolescents: about 33% of cases that do not affect children occur in adolescence and developmental age.

Adults may also be at risk of developing orchitis during adolescence.

Orchitis is often associated with other comorbidities in the subject: about 25% of men with mumps also have this inflammation, and 60% of those with this infection subsequently develop atrophy of at least one testicle.

The only way to be sure that you have contracted this disease is to have an examination by a specialist, which is also necessary in order to understand exactly what treatment to receive and what medicines to take.

Learn more about this disease, such as symptoms, causes, complications, and treatments.

What is orchitis

Orchitis is an inflammation that affects one or both testicles and is often associated with a more complex condition: mumps.

Thus, the main cause of this disease is a virus.

Mumps is a disease caused by a specific virus of the paramyxovirus family, which manifests itself as an enlargement of the parotid glands as symptoms and may be complicated by orchitis.

Orchitis can usually be associated with inflammation of the epididymis.

The name orchitis comes from orcheis, which means testicle, and the ending -itis, which instead takes on the meaning of an inflammatory process.

When the inflammatory pathology also affects the epididymis, this can be called orchiepididymitis.

This pathology can lead to great discomfort and complications on the part of the male reproductive apparatus, so early diagnosis and appropriate therapy to reduce inflammation is very important.

Symptoms of orchitis

Symptoms of orchitis can be varied and occur suddenly, within a few days after infection.

These symptoms may vary in intensity depending on the stage of inflammation and other factors such as age and lifestyle of the patient.

In addition, typical symptoms of this disease can also appear in only one testicle.

Among the most common symptoms of orchitis:

• severe pain in the groin, especially in the testicles;
• one or both testicles may be swollen and red;
• the penis may secrete and there may be blood in the semen;
• fever and nausea are very common symptoms in patients with orchitis;
• swelling of the scrotum, prostate and lymph nodes in the groin;
• pain during ejaculation;
• Headache;
• muscle pain.

Often in younger patients and men suffering from mumps, the first symptom is swelling of the salivary glands.

After the onset of this symptom, others may appear 4–7 days later.

Nausea, fever and muscle pain are the most common in this case.

Causes

The causes of orchitis are varied.

This inflammation can be bacterial, viral, parasitic, mycobacterial, prostatectomy, or traumatic.

Thus, the causes of orchitis depend on its origin:

• In the case of bacterial orchitis, inflammation is usually associated with the presence of epididymitis. This word is used to define inflammation of a specific area of ​​the male reproductive apparatus, the channel that serves as a link between the vas deferens and the testicle. This disease is usually caused by an infection of the bladder and urethra that spreads to this connecting canal, called the epididymis. In addition, this infection can also be transmitted sexually. In fact, bacterial orchitis mainly affects men in the sexually active age group, ie. from 19up to 35/40 years.
• Viral orchitis is often associated with the presence of mumps. In this case, the inflammation is a complication of the disease, better known as mumps. This acute infectious disease is an initial symptom of swelling of the salivary glands, and after a few days – the typical symptoms of orchitis.

Risk factors and complications

There are several risk factors that can lead to complications of orchitis and make it more likely to occur.

In particular, there are factors that can lead to infection with viral orchitis.

These include:

• Age over 45;
• not vaccinated against mumps;
• surgery of the urinary or genital tract;
• congenital anomalies of the urinary tract.

Inappropriate sexual behavior is another risk factor that can lead to an increased risk of contracting orchitis.

Sexual intercourse with different partners and lack of protection are by far the two biggest risk factors.

Condom use can help protect against this and other sexually transmitted diseases.

Most patients with orchitis can be cured without long-term complications.

However, despite this, there may be a number of complications, including infertility.

Other complications are abscesses or blisters in the scrotum, testicular stenosis, chronic inflammation of the epididymis, and death of testicular tissue.

Diagnosis of orchitis

Early diagnosis is essential in order to avoid complications and identify the causes of this inflammation at an early stage.

With immediate diagnosis, a specific treatment can be started that can solve the problem.

For the diagnosis of orchitis, certain tests and examinations are required:

• To detect inflammation, first of all, it is necessary to conduct a thorough clinical and anamnestic examination, during which it is possible to check for the presence of enlarged inguinal lymph nodes typical for this pathology and possible enlargement of the testicles;
• An ultrasound should then be performed to see if there is a change in blood flow. In addition, thanks to this ultrasound examination, a possible testicular torsion can be detected. These two tests check the health status of different areas of the testicle that are commonly affected by this type of inflammation.

Your doctor may then ask for additional tests, such as a blood culture or urethral swab.

These two tests are useful for checking for any sexually transmitted diseases.

prevention

Prevention of this disease depends on the cause.

If it depends on congenital disorders, prevention is possible through intervention to eliminate them.

Proper intimate hygiene helps prevent orchitis.

Viral orchitis can also be prevented if treated responsibly.

This type of inflammation is sexually transmitted and is especially common in men between the ages of 19 and 40.

Among these responsible preventive actions

• get the mumps vaccine whenever possible to prevent the disease known as mumps. Moreover, this vaccine is very useful because it also protects against diseases such as measles and rubella. This vaccine is usually given to children at two different times: 13 months and 5/6 years of age. Today, this vaccine is mandatory, but it can be requested by adults not vaccinated as children. In this case, the time between doses can be as little as four weeks.
• Avoid multiple sexual partners, which increases the likelihood of contact with an infected patient.
• Always use appropriate protection during intercourse, in particular use a condom every time you have sex, to avoid not only this, but also other sexually transmitted diseases.

Orchitis Therapy

Once the diagnosis is made by a medical specialist, similar treatments for orchitis are usually prescribed.

Depending on the severity of the inflammation, alternative treatments and second-line drugs may be added.

Orchitis is treated with antibiotics and cortisone.