Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience.
OBJECTIVE
the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO) reporting to the reference hospital in Southeastern Anatolia of Turkey.


METHODS
in this study, 27 male patients with brucellosis, who presented with epididymitis or epididymo-orchitis (EO) at the university hospital in Diyarbakir from 1998 to 2006, were included. They were compared with the other male patients. Positive blood culture or high agglutination titers of > 1/160 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis.


RESULTS
fourteen patients had unilateral EO. Leukocytosis was present in 10 patients; all of them had initial agglutination titers of > 1/160 and 10 patients had a positive blood culture. All patients received combined therapy with streptomycin for the first 21 days (or oral rifampicin for 6-8 weeks) with doxycycline or tetracycline for 6-8 weeks. All showed improvement, fever subsided in 3-7 days, and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year.


CONCLUSIONS
in brucellosis-endemic areas, clinicians encountering EO should consider the likelihood of brucellosis. In this study, young age was the most common risk factor, and leukocytosis and high CRP level were the most common laboratory findings. Most cases were unilateral. All patients responded to medical management very well. Conservative management with combination antibiotic therapy was adequate for managing BEO. Conclusively, brucellosis must be considered as a cause of orchitis, especially in endemic regions like Turkey.
Celen
Mustafa Kemal
MK
Department of Infectious Diseases and Clinic Microbiology, Medical School, Dicle University, Diyarbakir, Turkey, 21280.
Ulug
Mehmet
M
Ayaz
Celal
C
Geyik
Mehmet Faruk
MF
Hosoglu
Salih
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002006:Brucellosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D004823:Epididymitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009920:Orchitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies; D014421:Turkey; D055815:Young Adult
D000900:Anti-Bacterial Agents