背景:急性附睾-睾丸炎(AEO)正在成为儿童急性阴囊疼痛中越来越常见的鉴别诊断。在成年男性中已经注意到SARS-CoV-2有累及睾丸和附睾的倾向,影响精子和睾酮的产生。我们的文献检索显示,仅有1例儿童出现附睾睾丸炎的COVID-19病例报告。我们又介绍了三个接受AEO的孩子,所有从PCR确认的SARS-CoV-2感染中恢复。本文综述了小儿附睾-睾丸炎的炎症后病因,和SARS-CoV-2对睾丸的倾向。
方法:两名青春期前10岁的患者到急诊科就诊,有48小时的逐渐发作的单侧阴囊疼痛和同侧阴囊皮肤红斑增加的病史。一名15岁的男孩在其全科医生诊断为AEO后四天因持续症状而被转诊。在进一步的提问中,3人在阴囊症状出现前两周均有PCR证实的COVID感染,并且刚刚结束隔离期.然后使用关键词SARS-CoV-2,睾丸和小儿急性附睾-睾丸炎进行文献检索。
结论:SARS-Cov-2病毒有影响睾丸和附睾的倾向。这使患者在COVID感染期间发生急性附睾睾丸炎的风险增加。病毒引起的炎症似乎会影响负责睾丸激素产生和精子质量的细胞。然而,没有证据表明病毒可以通过精液传播。
结论:SARS-Cov-2感染可导致急性附睾-睾丸炎。了解这一点具有临床意义,首先是为了避免由于睾丸扭转的误诊而进行不必要的手术干预,其次,由于病毒可能会影响精子质量和睾丸激素的产生。
Acute epididymo-
orchitis (AEO) is becoming an increasingly common differential diagnosis in children with acute scrotal pain. It has been noted in adult men that SARS-CoV-2 has a propensity for involving the testis and epididymis, affecting sperm and testosterone production. Our literature search revealed only one
case report of COVID-19 presenting with epididymo-
orchitis in a child. We present three more children who presented with AEO, all recovering from PCR-confirmed SARS-CoV-2 infection. This article reviews the post-inflammatory aetiology of paediatric epididymo-
orchitis, and the propensity SARS-CoV-2 has for the testis.
Two pre-pubertal ten-year-old patients presented to the emergency department with a 48-h history of gradual onset unilateral scrotal pain and increasing erythema of the ipsilateral scrotal skin. One fifteen-year-old boy was referred for ongoing symptoms four days following a diagnosis of AEO made by his General Practitioner. On further questioning, all three had PCR-confirmed COVID infection two weeks prior to the onset of their scrotal symptoms and had just ended their isolation period. A literature search was then performed using the keywords SARS-CoV-2, testes and paediatric acute epididymo-orchitis.
The SARS-Cov-2 virus has a propensity for affecting the testis and epididymis. This puts patients at increased risk of acute epididymo-
orchitis during COVID infections. The inflammation induced by the virus appears to affect the cells responsible for testosterone production and sperm quality. However, there is no evidence that viral transmission can happen via semen.
SARS-Cov-2 infection can lead to acute epididymo-
orchitis. Knowledge of this is clinically significant, firstly to avoid unnecessary surgical intervention due to a mistaken diagnosis of testicular torsion and secondly, due to the potential of the virus to affect sperm quality and testosterone production.