Acute parotitis orchitis

　　1, Etiology

　　Parotitis virus infection is the most common cause of orchitis.

　　2, Pathogenesis

　　Visibly, the testicles are highly enlarged and blue. When incising the testicles, due to the stromal reaction and edema, the seminiferous tubules cannot be squeezed out. Histologically, interstitial edema and vascular dilation are observed, with a large number of segmented neutrophils, lymphocytes, and macrophages infiltrating, and the seminiferous tubules are dilated, with inflammatory cells visible in the lumen. During the healing of orchitis, the testicles become smaller and softer. Spermatogenic cells in the seminiferous tubules disappear, interstitial lymphocytes infiltrate, and fibrosis and glassy degeneration occur.

　　About 30% of patients with orchitis caused by epidemic parotitis suffer from irreversible destruction of sperm. The affected testicles are highly atrophic. In the case of bilateral orchitis, it can lead to male infertility, but androgen levels are generally normal. Testicular pain may be accompanied by fever, chills, nausea, vomiting, and other systemic symptoms, usually appearing 3 to 4 days after the onset of parotitis. The scrotum becomes red and swollen, the testicles enlarge, and there is marked tenderness.

　　1, History of parotitis, parotid swelling, red and swollen parotid orifices, and secretion upon palpation.

　　2, Testicular pain, which may be accompanied by fever, chills, nausea, vomiting, and other systemic symptoms, usually appears 3 to 4 days after the onset of parotitis.

　　3. Scrotal swelling, testicular enlargement, and significant tenderness.

　　Live attenuated mumps vaccine is a powerful preparation for preventing mumps and its complications, such as orchitis. Generally, susceptible children under 1 year of age can be vaccinated. It can also be used as mumps hyperimmune globulin 20ml, injected during the incubation period of the disease to alleviate the development of the disease. The routine use of estrogen or adrenal corticosteroids may have a preventive effect on orchitis in children with mumps, but there is still controversy at present.

　　1. Laboratory examination may show an increase in blood leukocytes, urine analysis is mostly normal, and sometimes protein or microscopic hematuria can be seen. Pathogenic viruses can be found in urine during the acute phase. In addition, fluorescent immune technology can detect viral antibodies in serum.

　　2. Color Doppler ultrasound is an effective auxiliary diagnostic method, which can exclude torsion of the testicle and its accessories, and at the same time confirm the inflammation of the testicle and epididymis.

　　In addition to routine treatment, attention should also be paid to the following aspects in diet for patients with acute parotitis orchitis: diet should be light, and it is best to choose easily digestible and absorbable foods such as vegetable congee and noodle soup.

　　I. Treatment

　　1. Antibiotics are ineffective for this disease, and symptomatic treatment is mainly used. Bed rest, local cold or hot compress, elevate the testicles to reduce discomfort, and analgesics and antipyretics can be used according to the situation.

　　2. The use of adrenal cortical hormones has a definite therapeutic effect on the serum of patients in the recovery period.

　　3. 20ml of 1% lidocaine at low position varicocele occlusion, improve testicular blood flow, protect spermatogenic function.

　　4. Interferon has a good therapeutic effect on acute parotitis and viral orchitis, and also has a significant effect on preventing testicular atrophy.

　　II. Prognosis

　　Bilateral lesions can cause irreversible destruction of spermatogenic activity, leading to infertility. The acute phase of orchitis caused by mumps usually lasts for 1 week. Testicular atrophy can be observed within 1 to 2 months after onset.