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采用双重口服药物方案成功治疗布鲁氏菌性附睾炎-睾丸炎:一例伴有恶性肿瘤和结核病鉴别诊断的病例报告

Brucella epidydimo-orchitis successfully treated with dual oral drug regimen: A case report with differential diagnoses of malignancy and tuberculosis.

作者信息

Nahas Renad S, Alsulami Abdulsalam, Lashkar Manar O, Thabit Abrar K

机构信息

Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, 7027 Abdullah Alsulaiman St, Jeddah 22254-2265, Saudi Arabia.

Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, 7027 Abdullah Alsulaiman St, Jeddah 22254-2265, Saudi Arabia.

出版信息

Radiol Case Rep. 2022 Jul 27;17(10):3485-3489. doi: 10.1016/j.radcr.2022.07.012. eCollection 2022 Oct.

Abstract

Brucellosis is a zoonotic disease caused by spp. When complicated, may affect any organ system, including the genitourinary system in the form of epidydimo-orchitis. orchitis is the second most common form of complicated brucellosis. The present case is for an adolescent who is otherwise healthy but presented with right testicular pain. Ultrasound imaging showed heterogeneous enlarged right testis with large heterogeneous mass and central necrosis. α-fetoprotein was normal and β-human choriogonadotropin was negative. Malignancy and tuberculosis were excluded based on histopathology and microbiology of the tissue biopsy, respectively. The history of raw dairy consumption and positive serology for and established the diagnosis of epidydimo-orchitis. Treatment was successful with doxycycline and rifampin for four weeks. In pediatrics, it is important to rule out malignancy and make every attempt to avoid orchidectomy by making necessary investigations and involving infectious diseases consultation.

摘要

布鲁氏菌病是一种由布鲁氏菌属引起的人畜共患病。病情复杂时,布鲁氏菌病可能会影响任何器官系统,包括以附睾炎或睾丸炎形式出现的泌尿生殖系统。睾丸炎是复杂型布鲁氏菌病的第二常见形式。本病例为一名原本健康的青少年,但出现右侧睾丸疼痛。超声成像显示右侧睾丸不均匀肿大,伴有较大的不均匀肿块和中央坏死。甲胎蛋白正常,β人绒毛膜促性腺激素为阴性。分别根据组织活检的组织病理学和微生物学排除了恶性肿瘤和结核病。食用生乳制品的病史以及布鲁氏菌和马尔他布鲁氏菌血清学检测呈阳性,确诊为布鲁氏菌性附睾炎。使用强力霉素和利福平治疗四周后取得成功。在儿科,通过进行必要的检查并咨询传染病专家,排除恶性肿瘤并尽一切努力避免进行睾丸切除术非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3296/9334919/149be9548e80/gr1.jpg

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