Mackenzie H, Mahmalji W, Raza A
Department of Urology, Ealing Hospital NHS Trust, Middlesex, UK.
Int J STD AIDS. 2011 Sep;22(9):531-3. doi: 10.1258/ijsa.2009.009442.
A 47-year-old man presented to his general practitioner (GP) with painful swelling of his right testis. He was diagnosed with epididymo-orchitis and a two-week course of erythromycin 500 mg four times daily was prescribed by his GP. Despite initial improvement, his symptoms persisted and he was referred to the local urology department. His sexual history revealed one lifetime sexual contact. A midstream urine sample grew non-lactose fermenting coliforms sensitive to ciprofloxacin and a two-week course of ciprofloxacin 500 mg two times daily was prescribed. Despite clinical improvement, a persistent suspicious abnormality on the ultrasound scan of his right testis prompted a right radical inguinal orchidectomy to exclude malignancy. Further diagnostic tests including histopathology excluded malignancy but confirmed tertiary syphilis. A comprehensive literature search revealed only 11 confirmed cases in the past 59 years.
一名47岁男性因右侧睾丸疼痛肿胀就诊于他的全科医生（GP）。他被诊断为附睾炎，全科医生给他开了为期两周的红霉素，每日4次，每次500毫克。尽管最初症状有所改善，但仍持续存在，于是他被转诊至当地泌尿外科。他的性病史显示其一生仅有一次性接触。中段尿样本培养出对环丙沙星敏感的非乳糖发酵大肠菌，于是给他开了为期两周的环丙沙星，每日2次，每次500毫克。尽管临床症状有所改善，但右侧睾丸超声扫描持续存在可疑异常，促使进行了右侧根治性腹股沟睾丸切除术以排除恶性肿瘤。包括组织病理学在内的进一步诊断检查排除了恶性肿瘤，但确诊为三期梅毒。全面的文献检索显示，在过去59年中仅有11例确诊病例。
