Fig. 1 Specimen and examination

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Key words: Acute epididymitis, Chlamydia trachomatis, Ureaplasma urealyticum

Fig. 1 Specimen and examination

Table 1 Underlying diseases of 58 patients with acute epididymitis B. P. H. *: Benign prostatic hypertrophy Table 2 Organisms isolated from urethral swab

Table 3 Organisms isolated from midstream urine Table 5 Number of chlamydial inclusions G. N. R. *: Gram negative rod G. P. C. **: Gram positive coccus NF-GNR* * *: Glucose nonfermentative gram negative rod Table 4 Frequency of isolation of C. trachomatis from epididymal aspirates : C. trachomatis was detected by EIA (Chlamydiazyme).

Table 6 Frequency of isolation of C. trachomatis, U. urealyticum and bacteria from patients with and without underlying disease Table 7 Quantitative culture of U. urealyticum from urethral swab *: K coli (105 CFU/ml) was isolated from urine in one case. Table 8 Antibody to C. trachomatis in 21 patients with acute epididymitis *: p<0.01

Table 9 Relationship between age and isolation frequency of organisms U. urealyticum*: Cases with monomicrobial infection of U. urealyticum

Table 10 Comparison of Chlamydia-positive and bacteria-positive epididymitis in clinical features and laboratory findings PMNL 5*: 5 or more polymorphonuclear leukocytes per high-power field were seen in urethral smear.

Table 11 Relationship between medication period and clinical efficacy of minocycline (doxycycline)

1) Wolin, L.H.: On the etiology of epididymitis.

J. Urol., 105: 531-533, 1971. immunofluorescence antibody responses in Chlamydia trachomatis infection, A review. In Chlamydial Infections (Mardh, P.A., Holmes, 3) Harnisch, J.P., Berger, R.E., Alexander, E.R., K.K., Oriel, J.D., Piot, P. and Schachter, J. ed.) Monda, G. & Holmes, K.K.: Aetiology of p.301-316, Elservier Biomedical Press, Amsterdam, New York, Oxford, 1982. acute epididymitis. Lancet, 1: 819-821, 1977. 4) Evans, R.T. & Taylor-Robinson, D.: Comparison of various McCoy cell treatment proce- dures used for detection of Chlamydia trachomatis. J. Clin. Microbiol., 10: 198-201, 1979. 5) Kotani, H. & Ogata, M.: Isolation and serological grouping of ureaplasmas from dogs. Jap. J. Vet. Sci., 41: 639-646, 1979. 6) Wang, S. P.: A micro immunofluorescence method. Study of antibody resplonse to TRIC organisms in mice. In Trachoma and related disorders caused by chlamydial agents. (Nichols, R.L. ed.) p. 273-288, Excerpta Medica, Amsterdam, 1971. 7) Mittemeyer, B.T., Lennox, K.W. & Borski, A. A.: Epididymitis: A review of 610 cases. J. Urol., 95: 390-392, 1966. 8) Heap, G.: Acute epididymitis attributable to chlamydial infection Preliminary report. Med. J. Aust., 1: 718-719, 1975. 9) Berger, R.E., Alexander, E.R., Monda, G.D., Ansell, J., McCormick, G. & Holmes, K.K.: Chlamydia trachomatis as a cause of acute "idiopathic" epididymitis. N. Engl. J. Med., 298: 301-304, 1978. 10) M0ller, B.R. & Mardh, P.A.: Experimental epididymitis and urethritis in grivet monkeys provoked by Chlamydia trachomatis. Fertil. Steril., 34: 275-279, 1980. Walter, S.: Chlamydia trachomatis in acute epididymitis. Scand. J. Urol. Nephrol., 17: 47 50, 1983. - 13) Wang, S.P. & Grayston, J.T.: Micro 16) Beam, M.O., Saxon, E.M. & Tipple, M.A.: Treatment of chlamydial pneumonia of infancy. Pediatrics, 63: 198-203, 1979. 17) Taylor-Robinson, D. & Thomas, B.J.: The role of Chlamydia trachomatis in genital-tract and associated diseases. J. Clin. Pathol., 33: 205 233, 1980. - 19) Oriel, J.D., Reeve, P. & Nicol, C.S.: Minocycline in the treatment of nongonococcal urethritis: Its effect on Chlamydia trachomatis. J. Am. Vener. Dis. Assoc., 2: 17-22, 1975. 20) Johannisson, G., Sernryd, A. & Lycke, E.: Susceptibility of Chlamydia trachomatis to antibiotics in vitro and in vivo. Sex. Transm. Dis., 6: 50-57, 1979. 21) Osoba, A.O.: Epidemiology of urethritis in Ibadan. Br. J. Vener. Dis., 48: 116-120, 1972. 22) Coufalik, E.D., Taylor-Robinson, D. & Csonka, G.W.: Treatment of nongonococcal urethritis with rifampicin as a means of defining the role of Ureaplasma urealyticum. Br. J. Vener. Dis., 55: 36-43, 1979. 12) Scheibe', J.H., Andersen, J.T., Brandenhoff, P., 23) Becker, H.C., Weidner, W., Schiefer, H.G., Geerdsen, J.P., Bay-Nielsen, A., Schultz, B.A. & Brunner, H. & Krause, W.: Epididymitis. Dtsch. Med. Wochenschr., 109: 569-575, 1984.

The Role of Chlamydia trachomatis and Ureaplasma urealyticum in Department Patients with Acute Epididymitis Yasuhisa ITO of Urology, Gifu University School of Medicine (Director: Prof. Yukimichi KAWADA) 1) Fifty-eight patients suffering from acute epididymitis were investigated to assess the etiologic role of Chlamydia trachomatis and Ureaplasma urealyticum. Sixteen (42.1%) of the thirty-eight patients without underlying diseases yielded C. trachomatis from the urethral swabs, but no bacteriuria CFU/ml) was recovered. C. trachomatis was isolated from epididymal aspirates in 4 out of 10 patients in whom C. trachomatis was isolated from the urethral swabs. Of the twenty patients having underlying diseases, 11 men were associated with urinary tract infections, but C. trachomatis was not isolated from the urethral swabs from any of these patients. 2) The antibodies to C. trachomatis in 21 sera was determined by micro-immunofluorescence test. IgG antibodies to C. trachomatis were found in 88.9% (8/9) of the men with chlamydial infections and in 25% (3/12) of the men without chlamydial infections. IgM antibodies to C. trachomatis were not demonstrated in any case. 3) U. urealyticum was isolated from urethral swabs in 15 (25.9%) patients with acute epididymitis, but was not isolated from epididymal aspirates in any of the cases. In conclusion, C. trachomatis was regarded as the major pathogen in acute epididymitis, especially in patients without underlying diseases. But, the significance of U. urealyticum in acute epididymitis was not certain.

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