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附睾炎睾丸炎作为布鲁氏菌病患者的首发表现。

Epididymoorchitis as the first finding in patients with brucellosis.

作者信息

Karaköse Ayhan, Yuksel Mehmet Bilgehan, Aydoğdu Ozgü, Hamidi Aziz Ahmad

机构信息

Izmir University School of Medicine, Department of Urology, 35200 Izmir, Turkey.

Celal Bayar University, School of Medicine, Department of Urology, 45040 Manisa, Turkey.

出版信息

Adv Urol. 2013;2013:765023. doi: 10.1155/2013/765023. Epub 2013 Dec 26.

Abstract

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.

摘要

目的。急性阴囊疼痛作为布鲁氏菌病的首发症状很少见。我们旨在评估以附睾炎睾丸炎为初步诊断的男性布鲁氏菌病患者的数据。材料与方法。回顾了7例出现睾丸疼痛、充血、肿胀及发热加剧的患者的数据。对伴随的局部疾病以及临床、实验室和影像学检查结果进行了回顾性评估。结果。患者的平均年龄为22.28±7.78(16 - 35)岁。所有患者均出现阴囊疼痛、肿胀及出汗增多。其他表现分别为发热(6例)、乏力(5例)、关节痛(4例)、排尿困难(4例)、寒战及皮疹(3例)、体重减轻(2例)和呕吐(1例)。7例患者的虎红和wright凝集试验均为阳性。库姆斯试验仅3例患者为阳性。患者接受了抗生素及保守治疗。治疗后未观察到复发。结论。在流行地区,对于出现急性阴囊疼痛的患者,鉴别诊断时应考虑布鲁氏菌病引起的附睾炎睾丸炎。临床和血清学检查结果足以做出诊断。保守治疗联合抗生素治疗足以管理布鲁氏菌性附睾炎睾丸炎。

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