溶血孪生球菌感染引起附睾炎1例报道及文献回顾

Epididymitis caused by gemella haemolysans:a case report and literatures review

目的报道1例溶血孪生球菌引起附睾炎病例,结合文献探讨其临床特点、感染途径、鉴别诊断及治疗。方法对手术切除的1例附睾组织行常规病理检查,抽取患者鞘膜内积液送检验科行细菌培养及药敏实验。结果病检提示附睾组织查见炎细胞,病变符合附睾炎,送检鞘膜组织伴淋巴细胞、浆细胞、嗜酸性粒细胞浸润,组织学符合鞘膜积液伴慢性炎症;细菌培养提示:溶血孪生球菌感染,对氨苄青霉素、头孢唑啉、红霉素、先锋必、环丙氟哌酸等敏感。结论溶血孪生球菌引起附睾炎十分罕见,其诊断依赖临床及检验,一旦发现此类感染,首先确定病原菌,迅速治疗,防止发生溶血孪生球菌引起心内膜炎。

Objective To report a case of gemella haemolysans infection in epididymis, and discuss its clinical characteristics, infection pathway, differential diagnosis and treatment with literature review. Methods Routine pathological examination was performed on a epididymis tissue, and the patient＇s effusions in tunica vaginalis underwent germiculturc and sensitivity test in laboratory department. Results The pathological result showed inflammatory cells were found in epididymis tissue, and the lesions were epididymitis. Tunica vaginalis tissue had lymphocytes, plasma cells, and eosinophile granulocyte infiltration. The histology presentations accorded with effusions in tunica vaginalis with chronic inflammation. Germiculture showed gemella haemolysans infection, which was sensitve to penbritin, cefazolin, erythromycin, cefoperazone, ciprofloxacin and so on. Conclusion It is very rare to find gemella haemolysans infection in epididymis. Its diagnosis relies on the combination of clinical features and laboratory detecion. First, we should determine the pathogenic bacteria~ second, use sensitive antibiotic according to sensitivity test; and finally prevent gemella haemolysans infection in endocardium once infection is found.