Brusella epididymoorchitis: a retrospective evaluation of 22 cases

Objective: To evaluate retrospectively the clinical symptoms, laboratory findings, complications and treatment outcomes of patients with Brucellar epididymo-orchitis (BEO). Material and method: Between January 2012 and January 2017, 110 cases followed up with epididymoorchitis in our clinic were evaluated retrospectively. Of these, 22 were brusella epididymoorchitis. Positive clinical findings such as testicular pain, tenderness and scrotal swelling, positive Rose Bengal test results, ≥1 / 160 standard tube agglutination test titers or positive blood culture and ultrasonographic findings of orchitis were accepted as the main criteria for BEO diagnosis. Results: The mean patient age was 34.6 ± 17.8 years. BEO was one-sided in all patients. In 15 patients (68.2%) left, 7 patients (31.8%) had right-sided testicular involvement. Testicular pain and swelling were the most common symptoms. Sweating, fever, fatigue and anorexia were seen less frequently. The most common laboratory findings were increased ESR and CRP, 57.1% and 47.4%, respectively. Rose Bengal test positivity and ≥1 / 160 STA test titers were determined in all patients. Blood culture was positive for Brucella spp in 1 of 5 patients (20%). Since relapsing and the malignancy differential diagnosis can not be performed completely, in a patient radical orchiectomy was performed. All but 3 of 22 patients with BEO were successfully treated with rifampicin- doxycycline, or streptomycin-doxycycline combined antibiotic therapy. The overall medical care response rate was 86.3% in patients with correct pre-diagnosis. Conclusion: Brucellosis is a common cause of epididymo-orchitis in endemic areas. Early diagnosis and appropriate medical treatment in BEO prevent the development of complications such as abscess formation. For this reason, BEO should be considered as the cause of epididymorhosis in endemic regions and should be included in differential diagnosis in non-endemic regions