A 48-year-old male, born in Argentina, with no relevant personal history, with progressive pain of the left testicle of 2 months duration. He did not report urinary symptoms, no fever.
Treated with different antibiotic regimens without improvement.
On physical examination, a hard tumor was observed in a non-painful left test, with no signs of fluctuation.
Complementary tests: CBC: Lymphocytosis stands out, normal rest.
Urine sediment: Pyuria.
Urine culture: sterile.
Semen culture: E. coli (1o), S. Sprophiticus (2o), P. Mirabilis (3o).
Tumor markers: CEA, alpha fetofetal and BHCG normal.
Urine ultrasound: normal.
Testicular ultrasound : Heterogeneous left testicular tumor without liquid areas inside.
Mantoux was positive with ulceration.
The absence of clinical radiological improvement was realized radical orchiectomy being informed the pathological study of nonspecific orchitis.
1.
A sample is sent to microbiology, consisting of purulent exudate obtained intraoperatively from testicular tissue.
Auramine staining for mycobacteria was negative.
Gram stain showed polymorphonuclear leukocytes and few Gram(+) bacilli, some of them philate, with irregular staining and with bullous tips in the form of apples.
Genomic amplification (PCR) for M.tuberans was negative.
Detection of Chlamydia antigen was also negative.
Cultures for habitual bacteria, including Neiserias and Haemophilus, were negative at 72 hours of isolation.
After 96 hours, the growth of a microorganism highly adherent to the medium was detected in the culture. It was difficult to emulsify that Gram stain showed a modified morphology of Gram bacillus with coloryneformer-negative stain.
Phenotypic identification did not provide significant data for genetic study by 16SrRNA sequencing, identifying the strain as Corynebacterium thomsseni.
Cultures for non-contrast, mycobacteria were negative.
The isolated strain was very sensitive to Penicillin, Ampicillin, Amoxicillin with clavulanic acid, Cefotamin, Gentamicin, Amikacin, Triprim, Imiifpenem.
