Brucellosis of Testis and Epididymis: An Update of the Literature | Chapter 09 | Current Trends in Medicine and Medical Research Vol. 4
Background:
Brucellosis is a zoonotic disease which has the ability to afflict a number of
organs and tissues. Brucellosis epididymoorchitis (BEO),
a complication of
human brucellosis, can
emanate in complications. In
brucellosis non-endemic areas, some clinicians may be unfamiliar with the
disease entity which may lead to delay in the diagnosis.
Aim:
To review the literature on BEO, in order to document its presentation,
diagnosis, management and outcome following treatment as well as update the
literature related to the disease.
Methods:
Various internet data bases were usedto obtain literature on BEO.
Results /
Literature Review:
BEO (epididymitis plus or
minus orchitis) is
a complication of an
infection caused by
brucella species which
can be transmitted
via contact through
the respiratory tract, skin, or
conjunctiva, and through the gastrointestinal tract pursuant to ingestion of
unpasteurized milk/milk products or raw infected meat. BEO does in endemic
areas affect 2% to 20% of patients who have been afflicted by brucellosis but
the disease can also be encountered sporadically globally in non-endemic areas.
BEO could at times be bilateral. The manifestation of BEO is non-specific and
it could be mistaken for non-specific epididymo-orchitis or epididymitis or
testicular tumour or abscess. Ultrasound
scan and MRI
scan findings are
not specific to
BEO. Diagnosis of
BEO may be established by (a) history of contact, (b)
cultures from blood/epididymal aspirations, (c) various types of laboratory
studies including: (I) Culture, (II) PCR, and (III) serology. Laboratory test
criteria for the diagnosis of Brucellosis
is divided into
(I) those for
presumptive diagnosis and
(II) those for confirmatory diagnosis: BEO can be
effectively treated by means of combination chemotherapy for about six weeks
but at times orchidectomy or drainage of testicular collection may be necessitated for persistence of
symptoms or suspicion of a tumour / testicular abscess. Relapses of brucellosis
can occur hence careful follow-up of patients is required.
Conclusions:
BEO can occur anywhere globally. A high index of suspicion is thus required
from clinicians in order to establish early diagnosis of the disease.
Most cases of BEO can be effectively treated with combination chemotherapy for
about 6 weeks. Clinicians should be aware that brucellosis epididymo-orchitis,
brucellosis epididymitis and
epididymo-orchitis exist and
this condition could
be unilateral or bilateral, though more commonly encountered in
brucellosis endemic areas because of global travel the disease entity may be
encountered sporadically globally.
Author(s) Details
Mr Anthony Kodzo-Grey Venyo
MB ChB FRCS(Ed) FRCSI FGCS Urol. LLM
Department of Urology, North
Manchester General Hospital, Manchester, United Kingdom.
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