非定型抗酸菌と結核菌の混合感染による副睾丸炎

EPIDIDYMITIS BY MIXED INFECTION DUE TO MYCOBACTERIUM FORTUITUM AND TUBERCULOSIS

　症例は54歳で，左睾丸部の無痛性腫脹を主訴として来院した。初診時左睾丸および副睾丸は一塊となり小鶏卵大に腫大，陰嚢皮膚との癒着はなく発赤，圧痛，熱感等もみられなかった。検査成績では，血液および尿所見に異常は認めず，腫瘍マーカーもすべて正常であった。手術の結果は炎症性肉芽腫で，非定型抗酸菌と結核菌の混合感染による副睾丸炎であった。肺以外の非定型抗酸菌症は3％にしかみられず，非定型抗酸菌による副睾丸炎は非常に稀な疾患である。

A 54-year-old nurse aid male visited our hospital in Jan. 1988, complaining of slight testicular enlargement without any pain. He had no urinary symptoms. Physical examination showed almost normal. The firm, hen egg size mass, not clearly distinct from the testicle was palpable. All laboratory findings were within normal limit. Orchiectomy was done because malignancy was suspected. The epididymis involving the testicle was elastic hard, swollen and in part replaced by small abscesses. Microscopically, granulomatous epididymitis with giant cells were observed extending into the testis.