Epididymoorchitis as the First Finding in Patients with Brucellosis

Purpose. Acute scrotal pain as the first symptom of brucellosis is rarely observed. We aimed to evaluate the data of male patients with brucellosis and epididymoorchitis as the initial diagnosis. Material and Methods. The data of seven patients presented with testicular pain, hyperemia, swelling, and increased fever were reviewed. Concomitant focal diseases as well as clinical, laboratory, and radiological findings were retrospectively evaluated. Results. The mean age of the patients was 22.28 ± 7.78 (16–35) years. All patients presented with scrotal pain, swelling, and increased sweating. Additional findings included fever, asthenia, arthralgia, dysuria, shiver and rash, weight loss, and vomiting in 6, 5, 4, 4, 3, 2, and 1 patient, respectively. In all of 7 patients, the agglutination tests of Rose-Bengal and Wright were positive. Coombs test was positive only in 3 patients. The patients underwent antibiotic and conservative treatment. No relapse was observed following the treatment. Conclusion. In endemic regions, epididymoorchitis caused by brucellosis should be considered in the differential diagnosis of patients presenting with acute scrotal pain. Clinical and serological findings are sufficient for the diagnosis. Conservative management combined with antibiotic therapy is adequate for managing brucellar epididymoorchitis. 1. Introduction Brucellosis, which is also called Mediterranean or Malta fever, is an endemic enzootic disease and can involve various organ systems. Brucellosis constitutes a major health and economic problem in many parts of the world, encompassing the Mediterranean countries and Middle East [1, 2]. Epididymoorchitis is a focal form of human brucellosis with an incidence of 2–20% in patients with brucellosis [3, 4]. Brucella species cause granulomatous orchitis usually presenting as an acute or chronic unilateral swelling of the testis. Epididymoorchitis can be seen as a subsequent part of systemic disease after the previous diagnosis of Brucellosis. However, although the occurrence of Brucellar epididymoorchitis (BEO) as the presenting finding is an extremely rare manifestation of Brucellosis, patients can rarely apply to the clinicians with acute scrotum as an initial finding. Thus, BEO must be considered in the differential diagnosis of acute scrotum in endemic regions [5–9]. In the recent study, we aimed to describe the data of 7 patients who had no previous diagnosis of Brucellosis and were with BEO as a single, primary manifestation of the disease in endemic region of Mus, Turkey, and to present the importance of