Mumps orchitis: Report of a mini-epidemic
Mumps orchitis: Report of a mini-epidemic
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DOI：
10.1016/s0022-5347(01)68186-2
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发表时间：
1997-12-01
影响因子：
6.6
通讯作者：
Gasser, TC
中科院分区：
文献类型：
--
作者：
Casella, R;Leibundgut, B;Gasser, TC
目的：自从引入疫苗接种以来，腮腺炎睾丸炎的发病率急剧下降。以往我院腮腺炎病例只是偶发，近年来确诊病例急剧增加。 材料与方法：1995年6月至1996年4月期间，我院收治11例重症腮腺炎睾丸炎患者。记录每位患者的病史、治疗措施和临床结果。结果：所有患者均出现明显的阴囊肿胀，体温高于38.5℃。血清 C 反应蛋白显着升高（平均 140 毫克/升）。 11 名患者中有 1 名 (9%) 的疫苗接种状况未知。其余10名患者的医疗记录显示他们没有接种疫苗。九名患者（82%）在睾丸炎之前患有典型的腮腺炎腮腺炎。 2 名患者腮腺炎的临床诊断不确定，但腮腺炎血清学结果呈阳性。没有患者表现出腮腺炎的其他表现。 6 名患者检测出腮腺炎病毒抗体（IgG 和 IgM），所有病例均呈阳性。腮腺炎和睾丸炎发作之间的平均间隔为10天。所有患者平均住院6天。治疗包括卧床休息、局部降温、阴囊支持和非甾体类抗炎药全身治疗。由于初次就诊时不能排除细菌性睾丸炎，因此给予了环丙沙星或克拉维酸/阿莫西林。退烧的平均时间为 3.6 天（范围 3 至 5 天）。抗生素平均使用 8.8 天（范围 7 至 13），抗炎药物平均使用 8.6 天（范围 7 至 11）。一名患者需要进行阴囊探查。结论：自从推出针对腮腺炎病毒的疫苗以来，腮腺炎及其并发症的风险降低了。但如果出现阴囊肿胀，仍应考虑腮腺炎、睾丸炎。尽管接种了疫苗，腮腺炎仍未被根除。因此，继续接种疫苗应被视为最大限度地减少临床暴发并努力在未来可能根除这种疾病的重要一步。
Purpose: The incidence of mumps orchitis has declined dramatically since the introduction of vaccination. While in the past cases of mumps have only been seen occasionally at our institution, recently there has been a sharp increase in the number of confirmed cases.Materials and Methods: Between June 1995 and April 1996, 11 patients with severe mumps orchitis were hospitalized at our clinic. Medical history, therapeutic measures and clinical outcome were recorded for each patient.Results: All patients showed marked scrotal swelling with a temperature above 38.5C. Serum C-reactive protein was significantly elevated (mean 140 mg./l.). The vaccination status of 1 of the 11 patients (9%) was unknown. Medical records from the remaining 10 patients indicated that they had not been vaccinated. Nine patients (82%) had a typical mumps parotitis preceding the orchitis. In 2 patients the clinical diagnosis of parotitis was uncertain but mumps serology was positive. None of the patients showed other manifestations of mumps. Antibodies to the mumps virus (IgG and IgM) were determined in 6 patients and positive in all cases. The average interval between parotitis and onset of orchitis was 10 days. All patients were hospitalized for an average of 6 days. Treatment included bed rest with local cooling, scrotal support and systemic treatment with nonsteroidal anti-inflammatory drugs. Ciprofloxacin or clavulanic acid/amoxicillin was administered as bacterial orchitis could not be excluded at initial presentation. The mean time to cessation of fever was 3.6 days (range 3 to 5). Antibiotics were administered for an average of 8.8 days (range 7 to 13) and anti-inflammatory drugs were given an average of 8.6 days (range 7 to 11). One patient required scrotal exploration.Conclusions: Since the introduction of a vaccine against the mumps virus there is a diminished risk for mumps and its complications. However, in case of scrotal swelling mumps orchitis should still be considered. Despite vaccination mumps has not been erradicated. Therefore, continued vaccination should be considered an important step in minimizing clinical outbreaks and working towards a possible eradication of this disease in the future.