Endemic brucellar epididymo-orchitis: a 10-year experience.
OBJECTIVE
To present epidemiologic, clinical and laboratory features, treatment and outcome of patients suffering from Brucella melitensis-induced epididymo-orchitis, in comparison with cases of nonspecific epididymo-orchitis. Distinction between these two entities is essential, as treatment and outcome are entirely different.


METHODS
In this retrospective study, records of 17 patients serologically diagnosed as suffering from B. melitensis epididymo-orchitis were reviewed in comparison with 141 cases of non-Brucella epididymo-orchitis. All patients presented consecutively at a tertiary hospital in southwestern Greece, from 1991 to 2000. Statistical analysis was performed using the chi-square test.


RESULTS
B. melitensis epididymo-orchitis differed from nonspecific epididymo-orchitis, due to its high occupational risk, seasonal pattern, gradual onset (P<0.01), longer duration, typical undulatory fever (P<0.05), absence of serious leukocytosis (P<0.05) and lower urinary tract symptoms, and relatively minimal local signs of florid inflammation (P<0.01). Oral medication with doxycycline and rifampicin for 6 weeks was effective, and no relapses or serious side effects were recorded during the follow-up period.


CONCLUSIONS
B. melitensis-induced epididymo-orchitis is a recognized clinical problem in endemic regions, requiring early detection and appropriate medication. Clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis and initiate anti-Brucella medication upon clinical diagnosis and not only after serologic confirmation.
Papatsoris
Athanasios G
AG
Department of Urology, St Andrews Patras Regional Hospital, Greece. agpapatsoris@hotmail.com
Mpadra
Filitsa A
FA
Karamouzis
Michalis V
MV
Frangides
Christos Y
CY
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017347:Brucella melitensis / Q000302:isolation & purification*; D002006:Brucellosis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004318:Doxycycline / Q000627:therapeutic use; D019353:Endemic Diseases; D004823:Epididymitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D009920:Orchitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004318:Doxycycline; D012293:Rifampin