A complication of brucellosis: epididymoorchitis.
BACKGROUND
Epididymoorchitis is the most frequent genitourinary complication of brucellosis.


METHODS
This prospective study was conducted between February 2001 and January 2004, prospectively. Male patients diagnosed with brucellosis were included in this study and evaluated for testicular involvement.


RESULTS
Epididymoorchitis was detected in 17 out of 134 (12.7%) male patients with brucellosis. Mean age of the patients was 36.9+/-7.1 years. Twelve patients (70.6%) had acute, four patients (23.5%) had subacute, and one patient (5.9%) had chronic brucellosis. The most common symptoms were scrotal pain (94%) and swelling (82%). Eleven patients had unilateral epididymoorchitis, four had unilateral orchitis and two had unilateral epididymitis. A testicular abscess was detected in one patient. Sperm analysis was performed on 14 patients. Five patients had aspermia and eight had oligospermia. Combined antibiotic therapy was started and continued for 6-8 weeks. Orchiectomy was required for two patients and granulomatous orchitis was detected in the resected specimens. Relapse occurred in only one patient. Three patients had permanent oligospermia and one patient had permanent aspermia after the antibiotic therapy. Younger age, high C-reactive protein level and blood culture positivity were statistically significant differences between the patients with and without epididymoorchitis.


CONCLUSIONS
Brucellosis should be considered in the diagnosis of scrotal diseases in endemic areas. A conservative approach is usually adequate for managing brucellar epididymoorchitis. However, infertility problems may develop in these patients. Well-designed further investigations are needed to explain the relationship between brucellar epididymoorchitis and infertility in man.
Akinci
Esragül
E
Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey. esragulakinci@yahoo.com
Bodur
Hürrem
H
Cevik
Mustafa Aydin
MA
Erbay
Ayşe
A
Eren
Selim Sirri
SS
Ziraman
Ipek
I
Balaban
Neriman
N
Atan
Ali
A
Ergül
Gülüşan
G
D000328:Adult; D000372:Agglutination Tests; D002003:Brucella abortus / Q000472:pathogenicity; D017347:Brucella melitensis / Q000472:pathogenicity; D002006:Brucellosis / Q000150:complications* / Q000503:physiopathology; D016009:Chi-Square Distribution; D004822:Epididymis / Q000000981:diagnostic imaging; D004823:Epididymitis / Q000175:diagnosis / Q000209:etiology*; D005334:Fever; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D013737:Testis / Q000098:blood supply / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color; D015431:Weight Loss