Urology Department, General Hospital of Elefsina Thriassio, Elefsina, Greece.
Braz J Infect Dis. 2009 Apr;13(2):86-9. doi: 10.1590/s1413-86702009000200003.
We examined the clinical presentation and outcome of Brucellar infections of genitalia and the lower urinary tract through a review of the medical records of 10 cases of male patients with brucellar infections of the genitalia and lower urinary tract. The mean age of the patients with brucellosis was 49.2, (median 52, range 15-77 years). Eleven out of 17 patients were rural residents, 15 reported that they might have consumed unpasteurized dairy products, and four reported occupational exposure. Symptoms onset was acute in almost all cases. Scrotal pain, epidedimal swelling and fever were the most common symptoms. The Wright test was positive in 13 patients, while Brucella sp. was isolated from blood cultures in six cases. Only two patients were found with abnormal liver ultrasonography. All patients underwent treatment with doxycycline and aminoglycoside for seven days and doxycycline alone for two months. Most of them responded to antibiotic therapy with rapid regression of symptoms. One patient failed to respond to therapy and presented necrotizing orchitis, as well as abscesses, which required orchectomy. Brucellar infections of the genitalia and lower urinary tract have no specific clinical presentation; the usual laboratory examination is not sufficient to diagnose this kind of infection, therefore it could easily be misdiagnosed. An analytical medical history (including overall dietary habits and recent consumption of non-pasteurized dairy products) could indicate Brucellosis as would the persistence of symptoms despite a one-week antibiotic treatment. In general, patients afflicted by brucellar epididymoorchitis respond to Brucellosis antibiotic therapy, except for some rare cases that present necrotizing orchitis and require surgical treatment.
我们通过回顾 10 例男性生殖器和下尿路布鲁氏菌感染患者的病历，研究了生殖器和下尿路布鲁氏菌感染的临床表现和转归。布鲁氏菌病患者的平均年龄为 49.2 岁（中位数 52 岁，范围 15-77 岁）。17 例患者中有 11 例来自农村，15 例自述可能食用了未经巴氏消毒的奶制品，4 例自述职业暴露。几乎所有病例的症状均为急性发作。阴囊疼痛、附睾肿胀和发热是最常见的症状。13 例患者的 Wright 试验阳性，6 例从血培养中分离出布鲁氏菌。仅有 2 例患者的肝脏超声检查异常。所有患者均接受了 7 天的多西环素和氨基糖苷类药物治疗，以及 2 个月的多西环素单药治疗。大多数患者在接受抗生素治疗后症状迅速缓解。1 例患者对治疗反应不佳，出现坏死性睾丸炎和脓肿，需要行睾丸切除术。生殖器和下尿路布鲁氏菌感染无特异性临床表现；通常的实验室检查不足以诊断这种感染，因此很容易误诊。详细的病史（包括整体饮食习惯和近期食用未经巴氏消毒的奶制品）可提示布鲁氏菌病，即使在抗生素治疗 1 周后症状持续也可提示该病。一般来说，除了少数出现坏死性睾丸炎并需要手术治疗的病例外，布鲁氏菌性附睾睾丸炎患者对布鲁氏菌病的抗生素治疗有反应。
