Gonococcal tysonitis, a rare local complication of gonorrhea: a clinical study of 15 cases

Wenge Fan1, Qingsong Zhang2, Mei Wei1, Mongting Ai1, Zhijiang Fan1,3, Tingwang Jiang4
1Department of Dermatology, First People’s Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, People’s Republic of China
2Department of Dermatology, Traditional Chinese Medical Hospital of Changshu City, Changshu, People’s Republic of China
3Department of Urinary Surgery, First People’s Hospital of Changsha City, Changsha Hospital Affiliated To Soochow University, Changsha, People’s Republic of China
4Department of Clinical Laboratory, First People’s Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, People’s Republic of China

Tóm tắt

To investigate the incidence, clinical manifestations, and treatments of gonococcal tysonitis in men. We enrolled men with gonococcal tysonitis and men with gonococcal urethritis from January 2000 to December 2020. Demographic data, interval from non-marital sexual contact to the onset of symptoms of gonococcal tysonitis, occurrence sites, and manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with sinus-like lesions. Incision and drainage were performed in patients with non-ruptured abscesses. Fifteen patients with gonococcal tysonitis (0.29%; 95% confidence interval: 0.15–0.44%) were observed among 5087 patients with gonococcal urethritis. The mean age was 38.64 years (range, 17–74 years). The mean gonococcal tysonitis incubation period was 6.02 ± 1.37 days (range, 2–11 days). Lesions were present in the right side of the preputial frenulum in seven patients (46.67%), in the left side of the preputial frenulum in six patients (40%), and in both sides of preputial frenulum in two patients (13.33%). The lesions manifested as abscesses in 7 patients (46.67%), nodules in six patients (40%), and sinus-like lesions in two patients (13.33%); all lesions exhibited tenderness. All 15 patients were cured after treatment. Gonococcal tysonitis is a rare local complication of gonorrhea. Gonococcal urethritis with concurrent gonococcal tysonitis was less common than gonococcal urethritis with concurrent paraurethral gonococcal infection or gonococcal urethritis with concurrent gonococcal epididymitis. Gonococcal tysonitis lesions manifest as abscesses, nodules, and sinus-like lesions. Treatment with ceftriaxone is effective for gonococcal tysonitis.

Tài liệu tham khảo

Abdul Gaffoor PM (1986) Gonococcal tysonitis. Postgrad Med J 62(731):869–870. https://doi.org/10.1136/pgmj.62.731.869 Thami GP (2003) Applied anatomy of male and female reproductive tract. in: Sharma VK ed.Sexually transmitted diseasesand AIDS (IASSTO & AIDS) 1st ed. Vivabooks Private Ltd.pp 143–151 Ambrose K, Claude N (1969) Venereal diseases, 2nd edn. Davis, Philadelphia 144–161. Fiumara NJ (1977) Gonococcal tysonitis. Br J Vener Dis 53(2):145. https://doi.org/10.1136/sti.53.2.145 Burgess JA (1971) Gonococcal tysonitis without urethritis after prophylactic post-coital urination. Br J Vener Dis 47(1):40–41. https://doi.org/10.1136/sti.47.1.40 Subramanian S (1981) Gonococcal urethritis with bilateral tysonitis and periurethral abscess. Sex Transm Dis 8(2):77–78. https://doi.org/10.1097/00007435-198104000-00009 Gaffoor PM, Bayyari KH (1989) Gonococcal tysonitis: an unusual penile infection. Indian J Dermatol 34(4):90–91 el-Benhawi MO, el-Tonsy MH (1988) Gonococcal urethritis with bilateral tysonitis. Cutis 41(6):425–426 Harkness AH (1948) The pathology of gonorrhœa. Br J Vener Dis 24(4):137–147 Sherrard J (2014) Gonorrhoea. Medicine 42(6):323–326 Fan W, Zhang Q, Wang L, et al (2016) Risk factors associated with paraurethral duct dilatation following gonococcal paraurethral duct infection in men. PLoS One11: e0166355. https://doi.org/10.1371/journal.pone.0166355. Accessed 18 Nov 2016 (eCollection 2016) Chen JZ, Gratrix J, Brandley J et al (2017) Retrospective review of gonococcal and chlamydial cases of epididymitis at 2 Canadian sexually transmitted infection clinics, 2004–2014. Sex Transm Dis 44(6):359–361. https://doi.org/10.1097/OLQ.0000000000000602 Scott MJ Jr, Scott MJ Sr (1982) Primary cutaneous Neisseria gonorrhoeae infections. Arch Dermato 118(5):351–352 Ghosn SH, Kibbi AG (2004) Cutaneous gonococcal infections. Clin Dermatol 22(6):476–480. https://doi.org/10.1016/j.clindermatol.2004.07.001 Dickson SD, Alter SJ (2011) Cutaneous gonococcal abscess of the abdomen in a child. Pediatr Emerg Care 27(9):863–864. https://doi.org/10.1097/PEC.0b013e31822c2882 Lal A, Rapose A (2018) Gonococcal cellulitis: an (un)friendly bite. Infection 46(4):569–572. https://doi.org/10.1007/s15010-018-1132-6 Fitzpatrick JE, Gramstad ND, Tyler H Jr (1981) Primary extragenital cutaneous gonorrhe. Cutis 27(5):479–480 Fan W (2010) Gonococcal inflammation of paraurethral glands around the external urethral orifice in males: a commonly encountered disease? Int J STD AIDS 21(3):225–226. https://doi.org/10.1258/ijsa.2009.009485 Clifford GR, Krieger JN, Rein MF (1983) Gonococcal infection of the median penile raphe. J Urol 130(1):138–139. https://doi.org/10.1016/s0022-5347(17)50999-4 Fan W, Zhang Q, Jiang T (2014) Pathogen profile in men with inflammation of paraurethral glands. Sex Transm Infect 90(1):52–54. https://doi.org/10.1136/sextrans-2013-051180 Cyr SS, Barbee L, Workowski KA et al (2020) Update to CDC’s treatment guidelines for gonococcal infection. MMWR Morb Mortal Wkly Rep 69(50):1911–1916. https://doi.org/10.15585/mmwr.mm6950a6