title: Brucellar epididymo-orchitis: a retrospective multicenter study of 28 cases and review of the literature.
abstract: OBJECTIVE
  To review retrospectively the clinical symptoms, laboratory findings and treatment outcomes of patients with Brucellar epididymo-orchitis.
  
  
  METHODS
  Retrospective data of 28 patients with Brucellar epididymo-orchitis who admitted to four medical centers between 2005 and 2013 were retrospectively reviewed. Positive blood culture, positive Rose Bengal test results or high agglutination titres of ≥ 1/160 with the positive clinical and ultrasonographic findings of orchitis were accepted as the main criteria for Brucellar epididymo-orchitis.
  
  
  RESULTS
  The mean patient age was 31 ± 16.9 years. Testicular involvement was on the left side in 16 patients and on the right side in 11 patients, one had bilateral disease. Testicular pain and swelling were the most common symptoms and elevation of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leucocytosis were the most common laboratory findings. Initial treatment was orchidectomy in six patients due to malignancy suspicion. All but three patients were successfully treated with antibiotic combinations of rifampicin, doxycycline and streptomycin. Two of three treatment resistant patients underwent orchidectomy.
  
  
  CONCLUSIONS
  Brucellosis is a common cause of epididymo-orchitis in endemic regions. Early diagnosis and treatment is crucial in the management and thus it must be kept in mind in endemic and non-endemic regions.
authors.affiliation: Sarıkamış Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Kars, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Savasci
authors.affiliation: Sarıkamış Military Hospital, Department of Urology, Kars, Turkey. Electronic address: murat804@yahoo.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Zor
authors.affiliation: Gulhane Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karakas
authors.affiliation: Kafkas Application and Research Hospital of Medicine Faculty, Department of Infectious Diseases and Clinical Microbiology, Kars, Turkey.
authors.forename: Emsal
authors.initials: E
authors.lastname: Aydin
authors.affiliation: Kafkas Application and Research Hospital of Medicine Faculty, Department of Urology, Kars, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kocaaslan
authors.affiliation: Sarıkamış Military Hospital, Department of Radiology, Kars, Turkey.
authors.forename: N Cem
authors.initials: NC
authors.lastname: Oren
authors.affiliation: Gulhane Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Coskun
authors.affiliation: GATA Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Turhan
authors.affiliation: Gulhane Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
authors.forename: H Cem
authors.initials: HC
authors.lastname: Gul
authors.affiliation: Gulhane Military Hospital, Department of Pathology, Ankara, Turkey.
authors.forename: A Fuat
authors.initials: AF
authors.lastname: Cicek
authors.affiliation: Gulhane Military Hospital, Department of Urology, Ankara, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Aydur
authors.affiliation: Gulhane Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
authors.forename: Can Polat
authors.initials: CP
authors.lastname: Eyigun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002002:Brucella; D002006:Brucellosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D002648:Child; D004338:Drug Combinations; D004823:Epididymitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D009920:Orchitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations
keywords: Brucella; Epididymis; Granulomatous; Orchitis; Testis