Syphilis testis and epididymis
The Tertiary syphilis lesions eggs are quite common. There are the following forms of gummy lesion eggs: 1) gummy epididymitis and 2) gummy orchitis. Quite often there is a simultaneous failure of the epididymis and testis.
1. gummy epididymitis is characterized by the fact that the epididymis increases, it becomes dense; at the same time often marked seal and in eggs. Later comes a softening and opening to form a gummy infiltrate typical gummy ulcer healing scar. (Painless and afebrile for typical for gummy epididymitis unlike gonococcal epididymitis, which, by contrast, is characterized by pain and fever over.
2. gummy orchitis occurs in the form of eggs and gumma sarcocele gummosa.
Gunma egg is characterized by increasing its size, density and tuberosity. At the height of the development process in one any part appears redness of the skin and softening infiltrate followed by opening and formation of ulcers. The process takes place, as well as with epididymitis, painless and afebrile. The resulting plague has infiltrated smooth vertical edges and the bottom covered with necrotic decay.
- It is not always possible to make a diagnosis solely on the basis of the clinical picture. Diagnostic difficulty is permitted on the basis of serological tests, if they are positive. A negative serological reactions is recommended to resort to trial antisyphyllitic treatment. When testicular tuberculosis ulcer has saped edge fistulezny course, mild infiltrate in the circle.
- Sarcocele gummosa characterized by the following symptom: the egg increases to the size of a goose egg, and more on palpation marked density, painless; smooth surface of the testicle, may be less bumpy. Patients pay doctor’s attention to the fact that the egg is heavy that its weight gives them a sense of nagging pains in the spermatic cord. This picture reaches full development in the course of 1 to 2 months; course of the disease in the absence of a specific treatment for a long period – up to a year or more. It should be noted, however, that a specific treatment for this form of the testis lesions gives rapid effect such as in the testis gum: it decreases slowly and often does not reach the initial value due to the development of fibrous connective tissue.
Usually, there is loss of one testicle, but in some cases may be involved in the process and the other testicle.
When the diagnosis should be aware of sarcoma of the testicle. Please note that the sarcoma is characterized by a rapid current and the early appearance of metastases. However, based on clinical symptoms not only possible to put the final diagnosis. Crucial have serological tests or other hidden or obvious symptoms of syphilis. A negative serological reactions and the absence of other symptoms of syphilis is recommended to resort to trial antisyphyllitic treatment or when there are strong signs in favor of sarcoma – a surgical intervention.