title: Epididymoorchitis due to Brucella mellitensis: a retrospective study of 59 patients.
abstract: Epididymoorchitis is a focal form of human brucellosis described in 2%-20% of patients with brucellosis. We assessed 59 cases of Brucella epididymoorchitis (BEO) between 1991 and 1999. The median age of patients was 34 years (range, 15-75 years). The onset of symptoms was acute in 46 patients (78%). Scrotal pain and swelling (100% of patients), fever (88%), and sweating (73%) were the most common symptoms. Brucella species was isolated from blood cultures in 41 patients (69%) and from epididymal aspiration in 4 patients. Treatment consisted of a combination of a doxycycline and an aminoglycoside (n=39) or rifampin (n=10); trimethoprim-sulfamethoxazole with rifampin (n=3); or trimethoprim-sulfamethoxazole as monotherapy (n=7). The median duration of therapy was 45 days (range, 21-90 days). The infections of 9 patients (15%) failed to respond to therapy, and 15 patients relapsed (25%). Three patients with necrotizing orchitis whose infections were unresponsive to antibiotics required an orchiectomy. In general, classical brucellosis therapy is adequate for BEO.
authors.affiliation: Department of Internal Medicine, Unit of Infectious Diseases and Department of Pathology, Hospital General, 02006 Albacete, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Navarro-Martínez
authors.forename: J
authors.initials: J
authors.lastname: Solera
authors.forename: J
authors.initials: J
authors.lastname: Corredoira
authors.forename: J L
authors.initials: JL
authors.lastname: Beato
authors.forename: E
authors.initials: E
authors.lastname: Martínez-Alfaro
authors.forename: M
authors.initials: M
authors.lastname: Atiénzar
authors.forename: J
authors.initials: J
authors.lastname: Ariza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017347:Brucella melitensis; D002006:Brucellosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents