Pérez Fentes Daniel, Blanco Parra Miguel, Alende Sixto María, Grille José Lema, Cimadevila García Antonio, Toucedo Caamaño Valentín, Lamas Cederrón Pedro, Villar Núñez Manuel
Servicio de Urología, Unidad Médica de Alta Precoz, Complejo Hospitalario, Universitario de Santiago de Compostela, Santiago de Compostela, España.
Arch Esp Urol. 2005 Sep;58(7):674-7. doi: 10.4321/s0004-06142005000700014.
To report one case of unilateral acute orchiepididymitis due to Brucella and to review its diagnosis and treatment in the related literature.
We report the case of a 37-year-old-male with undulant fever, scrotal pain and swelling and osteoarticular involvement. Diagnosis was obtained by anamnesis, blood cultures and specific serologic tests for Brucella.
Antibiotic therapy with orally administered Doxycycline (6 weeks) and im-administered Streptomycin (3 weeks). Complete clinical resolution was achieved.
We must perform an exhaustive anamnesis looking for a history of contact with animals or ingestion of contaminated dairy products in endemic areas of Brucella when facing the case of orchiepididymitis resistant to usual antibiotic therapy. The diagnosis is based on Brucella spp. isolation in blood cultures and on positive serologic tests (Rose Bengal test, standard seroagglutination test, anti-Brucella Coombs test, Brucellacapt test). Doxycycline with Streptomycin or Rifampin for 6 weeks seems to be the most adequate combinations of antibiotics. Surgical treatment only in exceptional cases.
报告1例由布鲁氏菌引起的单侧急性睾丸炎附睾炎病例,并复习相关文献中其诊断和治疗方法。
我们报告1例37岁男性病例,该患者有波状热、阴囊疼痛肿胀及骨关节受累。通过病史采集、血培养及布鲁氏菌特异性血清学检测做出诊断。
采用口服多西环素(6周)及肌内注射链霉素(3周)进行抗生素治疗。临床症状完全缓解。
面对常规抗生素治疗无效的睾丸炎附睾炎病例时,我们必须进行详尽的病史采集,寻找在布鲁氏菌流行地区与动物接触史或摄入受污染乳制品的病史。诊断基于血培养中分离出布鲁氏菌属及血清学检测阳性(玫瑰红试验、标准血清凝集试验、抗布鲁氏菌库姆斯试验、布鲁氏菌捕获试验)。多西环素联合链霉素或利福平治疗6周似乎是最恰当的抗生素组合。仅在特殊情况下进行手术治疗。