title: Seminal infection with Ralstonia picketti and cytolysosomal spermophagy in a previously fertile man.
abstract: OBJECTIVE
  To determine the origin of large plaque-like cellular and acellular masses of debris found in the semen of a patient with otherwise normal semen quality and secondary infertility.
  
  
  METHODS
  A prospective case study.
  
  
  METHODS
  Academic andrology laboratory.
  
  
  METHODS
  Secondary infertility patient presenting for routine semen evaluation.
  
  
  METHODS
  Following diagnosis of a seminal infection, the patient was treated with an antibiotic.
  
  
  METHODS
  Semen quality parameters, semen culture, and electron microscopy identification of cytolysosomal spermophagy.
  
  
  RESULTS
  Semen culture identified a rare infection with Ralstonia picketti and electron microscopy showed massive neutrophil and cytolysosomal spermophagy. Both were eliminated after antibiotic therapy.
  
  
  CONCLUSIONS
  This case study documents a rare infection of the reproductive tract with Ralstonia picketti. Analysis of large seminal masses determined their origin to be primarily from acellular cytolysosomes. The presence of such masses in semen should be further evaluated, including semen culture.
authors.affiliation: Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, Utah 84108, USA. dcarrell@med.utah.edu
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Carrell
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Emery
authors.forename: Blake
authors.initials: B
authors.lastname: Hamilton
mesh_terms: D000328:Adult; D020562:Betaproteobacteria / Q000302:isolation & purification*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology*; D008297:Male; D008854:Microscopy, Electron; D011446:Prospective Studies; D012661:Semen / Q000382:microbiology*; D013094:Spermatozoa / Q000648:ultrastructure*