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[Brucella orchyoepididymitis: case report].

Daniel Pérez Fentes1, Miguel Blanco Parra, María Alende Sixto

  • 1Servicio de Urología, Unidad Médica de Alta Precoz, Complejo Hospitalario, Universitario de Santiago de Compostela, Santiago de Compostela, España. danielfentes@yahoo.es

Archivos Espanoles De Urologia
|November 22, 2005
PubMed
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Brucellosis can cause unilateral acute orchiepididymitis, presenting with fever and scrotal pain. Prompt diagnosis via serologic tests and blood cultures, followed by doxycycline and streptomycin, ensures complete clinical resolution.

Area of Science:

  • Urology
  • Infectious Diseases
  • Microbiology

Background:

  • Brucellosis is a zoonotic disease endemic in many regions, often associated with undulant fever and systemic symptoms.
  • Orchiepididymitis, inflammation of the testicle and epididymis, can be a rare manifestation of Brucellosis.
  • Diagnosis and treatment of Brucellosis-induced orchiepididymitis require specific clinical and laboratory approaches.

Observation:

  • A 37-year-old male presented with unilateral acute orchiepididymitis, accompanied by undulant fever, scrotal pain and swelling, and osteoarticular involvement.
  • The patient's medical history included potential exposure to Brucella through animal contact or contaminated dairy products.
  • Clinical suspicion was confirmed through anamnesis, blood cultures, and specific serologic tests for Brucella.

Findings:

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  • Successful treatment was achieved with a combination antibiotic regimen of oral doxycycline for 6 weeks and intramuscular streptomycin for 3 weeks.
  • Complete clinical resolution of orchiepididymitis and associated symptoms was observed post-treatment.
  • Brucella spp. isolation in blood cultures and positive serologic tests (Rose Bengal test, standard seroagglutination test, anti-Brucella Coombs test, Brucellacapt test) confirmed the diagnosis.

Implications:

  • Clinicians should consider Brucellosis in cases of orchiepididymitis resistant to standard antibiotic therapies, especially in endemic areas.
  • A thorough patient history focusing on potential exposure to Brucella is crucial for diagnosis.
  • Combination antibiotic therapy, typically doxycycline with streptomycin or rifampin for 6 weeks, is the recommended treatment, with surgery reserved for exceptional circumstances.