A complication of brucellosis:: Epididymoorchitis

Background: Epididymoorchitis is the most frequent genitourinary complication of brucellosis. Methods: This prospective study was conducted between February 2001 and January 2004, prospectively. Mate patients diagnosed with brucellosis were included in this study and evaluated for testicular involvement. Results: Epididymoorchitis was detected in 17 out of 134 (12.7%) mate patients with brucellosis. Mean age of the patients was 36.9 +/- 7.1 years. Twelve patients (70.6%) had acute, four patients (23.5%) had subacute, and one patient (5.9%) had chronic brucellosis. The most common symptoms were scrota[ pain (94%) and swelling (82%). Eleven patients had unitateral epididymoorchitis, four had unilateral orchitis and two had unilateral epididymitis. A testicular abscess was detected in one patient. Sperm analysis was performed on 14 patients. Five patients had aspermia and eight had oligospermia. Combined antibiotic therapy was started and continued for 6-8 weeks. Orchiectomy was required for two patients and granulomatous orchitis was detected in the resected specimens. Relapse occurred in only one patient. Three patients had permanent oligospermia and one patient had permanent aspermia after the antibiotic therapy. Younger age, high C-reactive protein level and blood culture positivity were statistically significant differences between the patients with and without epididymoorchitis. Conclusions: Brucellosis should be considered in the diagnosis of scrota[ diseases in endemic areas. A conservative approach is usually adequate for managing brucellar epididymoorchitis. However, infertility problems may develop in these patients. Well-designed further investigations are needed to explain the relationship between brucellar epididymoorchitis and infertility in man. (c) 2005 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.