Clinical Factors Associated with Brucella-Related Epididymo-Orchitis: A Retrospective Cohort Study

Background/Objectives: Brucella-related epididymo-orchitis (BEO) is one of the most common genitourinary complications of brucellosis. This study aimed to evaluate the clinical and epidemiological characteristics of BEO in male patients with brucellosis and to identify clinical factors associated with its development. Methods: In this retrospective single-center cohort study, adult male patients diagnosed with brucellosis were included. Patients with and without BEO were compared in terms of epidemiological, clinical, and laboratory characteristics. Multivariate logistic regression analysis was performed to identify clinical factors associated with BEO. Results: Among 262 male patients with brucellosis, BEO was identified in 44 (16.8%). Of these patients, 38 (86.4%) presented with local scrotal symptoms, and combined involvement of the epididymis and testis was observed in 30 patients (68.2%). In univariable analysis, the patients who developed BEO were younger (33 vs. 44 years, p < 0.001), more frequently presented with fever (59.1% vs. 31.2%, p < 0.001), and had a shorter symptom duration (2 vs. 4 weeks, p < 0.001). In addition, leukocyte counts and C-reactive protein levels were significantly higher in this group (p = 0.009 and p < 0.001, respectively). In multivariable analysis, younger age (OR: 0.959, 95% CI: 0.930-0.988, p = 0.006), shorter symptom duration (OR: 0.852, 95% CI: 0.745-0.975, p = 0.020), and the presence of fever (OR: 2.265, 95% CI: 1.103-4.652, p = 0.026) were independently associated with BEO. Conclusions: BEO is a clinically significant genitourinary complication in male patients with brucellosis, notably associated with younger age, shorter symptom duration, and a more pronounced inflammatory response. In endemic regions, BEO should be considered in the differential diagnosis of patients presenting with fever and acute scrotal symptoms.