小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 年龄 >19 岁
- 单侧阴囊疼痛和肿胀，渐进性发作
- 症状持续时间＜6 周
- 触痛
- 一侧阴囊灼热，出现红斑，肿胀
- 尿频与尿痛
- 脓性尿道分泌物
其他诊断因素
- 发热
- 阴囊内组织波动性肿胀或硬结
- 前列腺增大或触痛
危险因素
- 无保护性交
- 膀胱出口梗阻
- 尿路器械治疗
- 免疫抑制
- 血管炎
- 胺碘酮
- 腮腺炎
- 结核病（Tuberculosis, TB）暴露
诊断性检查
首要检查
- 尿道分泌物革兰氏染色
- 尿试纸试验
- 尿显微镜检查
- 尿液培养
- 尿道分泌物或首段尿的核酸扩增试验（NAAT），检测是否存在沙眼衣原体、淋病奈瑟菌和生殖支原体
- 尿道分泌物培养
需考虑的检查
- 阴囊彩色双功能超声检查
- 手术探查
- 采集 3 次清晨尿液标本进行抗酸杆菌染色、培养以及 NAAT，以检查有无结核分枝杆菌
- HIV 检查
- 梅毒检测
治疗流程
细菌感染
胺碘酮诱发
潜在血管炎
特发性或病毒性
结核性
撰稿人
作者
Ameeta E. Singh, BMBS(UK), MSc, FRCPC, FIDSA
Clinical Professor
Division of Infectious Diseases
University of Alberta
Edmonton
Canada
利益声明
AES declares that she has no competing interests.
鸣谢
Dr Ameeta E. Singh would like to gratefully acknowledge Dr Hossein Sadeghi-Nejad, Dr Lorenzo DiGiorgio, Dr Mary Garthwaite, and Dr Ian Eardley, previous contributors to this topic.
利益声明
HSN, LDG, and MG declare that they have no competing interests. IE is a consultant to Pfizer, Lilly, and Sanofi. He is a speaker for Lilly.
同行评议者
Sheldon Morris, MD, MPH
Assistant Professor
Division of Infectious Diseases
Department of Medicine
UCSD Antiviral Research Center
Division of Family Medicine
Department of Family and Preventive Medicine
UCSD La Jolla Family and Sports Medicine
San Diego
CA
利益声明
SM has received research funding support from NIH CHRP, CIRM, and Gilead Sciences. He has financial interests in Impact Biomedicines (now Celgene) and Forty Seven Inc. There is no conflict between these financial interests and any content in this topic.
Altaf Mangera, MBChB (Hons), MD, FRCS (Urol), FEBU
Consultant Urologist
Department of Urology
Royal Hallamshire Hospital
Sheffield
UK
利益声明
AM declares that he has no competing interests.
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