Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years-of-age with acute epididymitis

iClinic, Taihaku-Ku, Sendai, Japan.
International Journal of Urology (Impact Factor: 2.41). 12/2011; 19(3):234-8. DOI: 10.1111/j.1442-2042.2011.02917.x
Source: PubMed


Acute epididymitis is often associated with urethritis. Mycoplasma genitalium and Ureaplasma urealyticum have been considered as pathogens of urethritis. The aim of the present study was to determine the prevalence of these microorganisms in men with acute epididymitis.
A total of 56 men younger than 40 years-of-age with acute epididymitis were enrolled in the present study between January 2006 and June 2010. First-void urine specimens were subjected to culture of aerobic bacterial species, and examined for the presence of Chlamydia trachomatis, M. genitalium, M. hominis, U. parvum and U. urealyticum by polymerase chain reaction-based assays. Urethral swabs were cultured for Neisseria gonorrhoeae.
The number and percentage of patients positive for each microorganism were as follows: Gram-negative bacilli, 2% and 3.6%; Gram-positive cocci, 23% and 41.1%; N. gonorrhoeae, 3% and 5.4%; C. trachomatis, 28% and 50.0%; M. genitalium, 5% and 8.9%; M. hominis, 6% and 10.7%; U. parvum, 6% and 10.7%; and U. urealyticum, 5% and 8.9%. Among 25 men with non-chlamydial non-gonococcal epididymitis, who were negative for Gram-negative bacilli, M. genitalium or U. urealyticum was detected in one man each (4.0%), and M. hominis and/or U. parvum was detected in five (20.0%).
In men younger than 40 years-of-age with acute epididymitis, C. trachomatis is a major pathogen. The prevalence of genital mycoplasmas and ureaplasmas are lower, and the role of genital mycoplasmas and ureaplasmas in the development of acute epididymitis remains to be determined.

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Available from: Shin Ito, Oct 02, 2014
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    • "However, Takahashi et al. [11] reported that chlamydia trachomatis was detected in 29.3% of asymptomatic males who did not have pyuria. C. trachomatis may reach the epididymis through the urethra and cause acute epididymitis without prominent inflammation of the urethra [12]. In our cases, a major cause of epididymitis was idiopathic, with the exception of 5 patients (3 with urethritis and 2 with prostatitis). "
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    ABSTRACT: Acute epididymitis is considered to have an important role in children with scrotal pain. Recent reports have shown that urinalysis is not helpful for the diagnosis and treatment of acute epididymitis owing to negative microbiological findings. Therefore, we analyzed clinical and laboratory characteristics to examine the diagnostic yield of urinalysis in children. We retrospectively reviewed the medical records of 139 patients who were diagnosed with acute epididymitis from 2005 to 2011. Diagnosis was based on symptoms, physical findings, and color Doppler ultrasonography (DUS). To investigate the characteristics of epididymitis in children, the patients were divided into 3 groups: group A (aged less than 18 years, 76 patients), group B (18 to 35 years old, 19 patients), and group C (older than 35 years, 44 patients). There were statistically significant differences in age, symptom duration, hospital stays, and lesion location in each group. White blood cell count and serum C-reactive protein levels, pyuria, and positive urine culture results were statistically higher in the older age group. The most common cause of acute epididymitis in children was idiopathic (96.1%). In our group of children with epididymitis, 73 cases out of 76 (96.1%) resulted in negative pyuria in urinalysis. In addition, the most common cause of epididymitis was idiopathic. Because most urinalyses do not show pyuria, we believe that routine antibiotics may be not required in pediatric patients with epididymitis. If urinalysis shows pyuria with or without positive urine culture, antibiotics should be considered.
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