Epididymoorchitis due to Brucella mellitensis: a retrospective study of 59 patients

Clin Infect Dis. 2001 Dec 15;33(12):2017-22. doi: 10.1086/324489. Epub 2001 Nov 6.

Abstract

Epididymoorchitis is a focal form of human brucellosis described in 2%-20% of patients with brucellosis. We assessed 59 cases of Brucella epididymoorchitis (BEO) between 1991 and 1999. The median age of patients was 34 years (range, 15-75 years). The onset of symptoms was acute in 46 patients (78%). Scrotal pain and swelling (100% of patients), fever (88%), and sweating (73%) were the most common symptoms. Brucella species was isolated from blood cultures in 41 patients (69%) and from epididymal aspiration in 4 patients. Treatment consisted of a combination of a doxycycline and an aminoglycoside (n=39) or rifampin (n=10); trimethoprim-sulfamethoxazole with rifampin (n=3); or trimethoprim-sulfamethoxazole as monotherapy (n=7). The median duration of therapy was 45 days (range, 21-90 days). The infections of 9 patients (15%) failed to respond to therapy, and 15 patients relapsed (25%). Three patients with necrotizing orchitis whose infections were unresponsive to antibiotics required an orchiectomy. In general, classical brucellosis therapy is adequate for BEO.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Brucella melitensis*
  • Brucellosis / complications*
  • Brucellosis / diagnostic imaging
  • Brucellosis / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Orchitis / diagnostic imaging
  • Orchitis / drug therapy
  • Orchitis / etiology*
  • Orchitis / microbiology
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography

Substances

  • Anti-Bacterial Agents