Genitourinary brucellosis: results of a multicentric study

Area of Science:

• Infectious Diseases
• Urology
• Microbiology

Background:

• Brucellosis is a zoonotic disease with potential for multi-organ involvement.
• Genitourinary (GU) brucellosis is an underreported manifestation.
• Understanding the clinical spectrum and outcomes of GU brucellosis is crucial for effective management.

Purpose of the Study:

• To review clinical, laboratory, therapeutic, and prognostic data of genitourinary brucellosis.
• To present the largest case series on genitourinary brucellosis to date.
• To identify key diagnostic indicators for genitourinary brucellosis.

Main Methods:

• A multicentre retrospective study pooling data from 34 centers.
• Inclusion of adult patients with confirmed genitourinary brucellar involvement treated between 2000 and 2013.
• Analysis of clinical presentation, laboratory findings, treatment regimens, and patient outcomes.

Main Results:

• 390 patients with genitourinary brucellosis were analyzed; 90.2% were male.
• In males, the scrotum was the most frequent site (83.8%), presenting as epididymo-orchitis or orchitis.
• Pyelonephritis was significantly more common in female patients (86.8%) than in males (3.1%).
• Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were common, but leucocytosis was infrequent.
• Therapeutic failure (1.5%), relapse (1%), and infertility (0.25%) were low.

Conclusions:

• Genitourinary brucellosis presents differently in males and females, with scrotal involvement in men and pyelonephritis in women being characteristic.
• Absence of leucocytosis with mild to moderate inflammatory markers, alongside localized scrotal or renal symptoms, should raise suspicion for brucellosis.
• Prompt diagnosis and treatment are essential to minimize complications such as infertility.