Spermatozoitis

Spermatozoitis is an infection or inflammation of the semen or sperm, typically caused by bacterial contamination of the seminal fluid during ejaculation. The condition may arise when microorganisms from the urethra, prostate, or seminal vesicles ascend into the ejaculate. It is more common in men with chronic prostatitis, urethritis, or those who have undergone urethral instrumentation. Infections with common organisms such as E. coli, Klebsiella, Enterococcus, or Staphylococcus aureus are frequently identified.

Patients with spermatozoitis often present with burning or pain during ejaculation, a metallic or foul taste in the semen, erythema or swelling of the scrotum, and sometimes tenderness of the prostate or perineum. In some cases, the condition is asymptomatic and detected only during semen analysis for infertility workup. The inflammatory reaction may also manifest as leukocytes within the semen, occasionally accompanied by increased seminal fluid viscosity.

Diagnosis is based on clinical history, physical examination, and laboratory tests. Semen analysis is essential, looking for pyuria, leukocytospermia, or bacterial growth. Urine culture and prostatic fluid sampling may be performed to identify the offending organism. Imaging studies, such as transrectal ultrasound, can evaluate prostatic or seminal vesicle involvement if indicated.

Treatment generally involves antibiotic therapy tailored to culture sensitivities, usually for 7 to 14 days. Benzylpenicillin, fluoroquinolones, or cephalosporins have shown effectiveness. Symptomatic relief with antispasmodics or non‑steroidal anti‑inflammatory drugs may be added. Men are advised to abstain from ejaculation for a period after starting therapy to ensure eradication of the infection. Repeat semen analysis after treatment helps confirm resolution.

The prognosis is good when treated appropriately, but untreated spermatozoitis can lead to chronic prostatitis, infertility due to sperm damage, or secondary testicular inflammation. Prevention focuses on maintaining sexual hygiene, promptly treating urethral or urinary tract infections, and avoiding invasive urinary procedures without prophylactic antibiotics.