Roushan Mohammad Reza Hasanjani, Baiani Masomeh, Javanian Mostafa, Kasaeian Ali Akbar
Department of Infectious Diseases, Yahyanejad Hospital, Babol Medical University, Babol.
Scand J Infect Dis. 2009;41(6-7):440-4. doi: 10.1080/00365540902968043.
From September 1998 to December 2008, 53 cases of brucellar epididymo-orchitis were treated and followed. The mean age of the patients was 35.5+/-15.9 y. 26 (49.1%) subjects had orchitis. Scrotal pain and swelling, fever, sweating, and arthralgia or arthritis occurred in 53 (100%), 43 (84.3%), 40 (78.4%) and 25 (47.1%) cases, respectively. 16, 20, 9 and 8 cases were treated with gentamicin for 7 d plus doxycycline for 45 d (GD), cotrimoxazole plus doxycycline (CD) for 45 d, streptomycin for 2 weeks and doxycycline (SD) for 45 d, and cotrimaxazole plus rifampin (CR) for 45 d, respectively. We continued the oral agents in all regimens for 2 months in those not clinically cured. At 45 d, cure rates were 48.3%, 65%, 77.8% and 50%, respectively, and at 2 months they were 87.5%, 90%, 100% and 75%, for GD, CD, SD and CR, respectively. In conclusion, scrotal pain and swelling, fever, sweating and arthralgia or arthritis were the main clinical findings in brucellar epididymo-orchitis patients. An aminoglycoside containing combination therapy was usually efficacious. Cotrimoxazole plus doxycycline may be an alternative regimen for those who cannot take an aminoglycoside.
1998年9月至2008年12月，对53例布鲁氏菌性附睾炎-睾丸炎患者进行了治疗及随访。患者的平均年龄为35.5±15.9岁。26例（49.1%）患者患有睾丸炎。阴囊疼痛和肿胀、发热、出汗以及关节痛或关节炎分别出现在53例（100%）、43例（84.3%）、40例（78.4%）和25例（47.1%）患者中。分别有16例、20例、9例和8例患者接受了以下治疗：庆大霉素治疗7天加强力霉素治疗45天（GD）、复方新诺明加强力霉素（CD）治疗45天、链霉素治疗2周加强力霉素（SD）治疗45天、复方新诺明加利福平（CR）治疗45天。对于临床未治愈的患者，所有治疗方案中的口服药物均持续使用2个月。在45天时，GD、CD、SD和CR方案的治愈率分别为48.3%、65%、77.8%和50%；在2个月时，治愈率分别为87.5%、90%、100%和75%。总之，阴囊疼痛和肿胀、发热、出汗以及关节痛或关节炎是布鲁氏菌性附睾炎-睾丸炎患者的主要临床表现。含氨基糖苷类药物的联合治疗通常有效。对于不能使用氨基糖苷类药物的患者，复方新诺明加强力霉素可能是一种替代方案。
