Haemophilus Influenzae Epididymo-Orchitis and Bacteraemia in an Immunocompetent Patient

Abdelhadi Farouji; Ahmad W Haddad; Nibras Yar Khan; Arwa Battah; Amaar S Ahmad; Jihad Slim

doi:10.12890/2023_004205

Haemophilus Influenzae Epididymo-Orchitis and Bacteraemia in an Immunocompetent Patient

Eur J Case Rep Intern Med. 2023 Dec 15;11(1):004205. doi: 10.12890/2023_004205. eCollection 2024.

Authors

Abdelhadi Farouji¹, Ahmad W Haddad¹, Nibras Yar Khan¹, Arwa Battah¹, Amaar S Ahmad¹, Jihad Slim²

Affiliations

¹ Department of Internal Medicine, Saint Michael's Medical Center, New York Medical College, Newark, USA.
² Department of Infectious Diseases, Saint Michael's Medical Center, New York Medical College, Newark, USA.

Abstract

Background: Epididymitis is a common cause of scrotal pain in adults, with coliform bacteria being the most common isolated organisms in patients older than 35.

Case presentation: A 51-year-old healthy patient presented with scrotal pain and swelling, and was found to have epididymo-orchitis and bacteraemia caused by Haemophilus influenzae, which has not previously been reported as a cause of epididymo-orchitis and bacteraemia in immunocompetent patients.

Discussion: Diagnostic studies can help confirm the diagnosis and detect the causative pathogen. In all suspected cases, a urinalysis, urine culture and a urine or urethral swab for nucleic acid amplification tests (NAATs) for Neisseria gonorrhoeae and Chlamydia trachomatis should be performed. Colour Doppler ultrasonography often shows an enlarged thickened epididymis with increased Doppler wave pulsation in epididymitis. H. influenzae are pleomorphic gram-negative rods that commonly colonise the human respiratory tract and are associated with a number of clinical conditions. H. influenzae has been reported as a cause of epididymo-orchitis in prepubertal boys, and in few cases were associated with positive blood cultures. In adults, H. influenzae has been isolated before from urine samples or urethral swabs in patients with epididymitis or epididymo-orchitis.

Conclusion: This case highlights the possibility of H. influenzae causing epididymo-orchitis and bacteraemia in immunocompetent patients. Healthcare providers should consider H. influenzae in the differential diagnosis of epididymitis and epididymo-orchitis in both immunocompetent and immunocompromised patients.

Learning points: H. influenzae can cause epididymo-orchitis and bacteraemia in immunocompetent patients. This has not been previously reported.H. influenzae should be considered in the differential diagnosis of epididymitis and epididymo-orchitis in both immunocompromised and immunocompetent patients.Healthcare providers should be aware of the increasing incidence of epididymitis and epididymo-orchitis caused by non-coliform bacteria in patients older than 35 years, especially in immunocompromised patients.

Keywords: Haemophilus influenzae; epididymo-orchitis; immunocompetent.