Haemophilus influenzae epididymo-orchitis and bacteraemia in an immunocompetent patient
  • Abdelhadi Farouji
    Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA
  • Ahmad W. Haddad
    Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA
  • Nibras Yar Khan
    Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA
  • Arwa Battah
    Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA
  • Amaar S. Ahmad
    Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA
  • Jihad Slim
    Department of Infectious Diseases, Saint Michael's Medical Center, New York Medical College, Newark, USA

Keywords

Haemophilus influenzae, epididymo-orchitis, immunocompetent

Abstract

Background: Epididymitis is a common cause of scrotal pain in adults, with coliform bacteria being the most common isolated organisms in patients older than 35.
Case presentation: A 51-year-old healthy patient presented with scrotal pain and swelling, and was found to have epididymo-orchitis and bacteraemia caused by Haemophilus influenzae, which has not previously been reported as a cause of epididymo-orchitis and bacteraemia in immunocompetent patients.
Discussion: Diagnostic studies can help confirm the diagnosis and detect the causative pathogen. In all suspected cases, a urinalysis, urine culture and a urine or urethral swab for nucleic acid amplification tests (NAATs) for Neisseria gonorrhoeae and Chlamydia trachomatis should be performed. Colour Doppler ultrasonography often shows an enlarged thickened epididymis with increased Doppler wave pulsation in epididymitis. H. influenzae are pleomorphic gram-negative rods that commonly colonise the human respiratory tract and are associated with a number of clinical conditions. H. influenzae has been reported as a cause of epididymo-orchitis in prepubertal boys, and in few cases were associated with positive blood cultures. In adults, H. influenzae has been isolated before from urine samples or urethral swabs in patients with epididymitis or epididymo-orchitis.
Conclusion: This case highlights the possibility of H. influenzae causing epididymo-orchitis and bacteraemia in immunocompetent patients. Healthcare providers should consider H. influenzae in the differential diagnosis of epididymitis and epididymo-orchitis in both immunocompetent and immunocompromised patients.

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References

  • Khanna K, Liu DR. Epididymitis and orchitis. In: Hoffman RJ, Wang VJ, Scarfone RJ, Godambe SA, Pitetti R, editors Fleisher and Ludwig's 5-Minute Pediatric Emergency Medicine Consult, Philadelphia: Lippincott Williams & Wilkins 2012; p. 262–263.
  • Tracy CR, Steers WD, Costabile R. Diagnosis and management of epididymitis. Urol Clin North Am 2008;35:101–108.
  • Greenfield SP. Type B hemophilus influenzae epididymo-orchitis in the prepubertal boy. J Urol 1986;136:1311–1313.
  • Dingle TC, Clarridge JE. Clinical significance and characterization of Haemophilus influenzae type b genogroup isolates from urine samples in an adult male population. J Clin Microbiol 2014;52:1745–1748.
  • Cross JT Jr, Davidson KW, Bradsher RW Jr. Haemophilus influenzae epididymo-orchitis and bacteremia in a man infected with the human immunodeficiency virus. Clin Infect Dis 1994;19:768–769.
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    Published: 2023-12-15
    Issue: 2024: Vol 11 No 1 (view)


    How to cite:
    1.
    Farouji A, Haddad AW, Yar Khan N, Battah A, Ahmad AS, Slim J. Haemophilus influenzae epididymo-orchitis and bacteraemia in an immunocompetent patient. EJCRIM 2023;11 doi:10.12890/2023_004205.