Khodadadi Javad, Dodangeh Milad, Nasiri Maryam
Department of Infectious Diseases, Faculty of Medicine, Qom University of Medical Sciences, Qom, Islamic Republic of Iran.
MD-MPH, Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
IDCases. 2023 Mar 6;32:e01736. doi: 10.1016/j.idcr.2023.e01736. eCollection 2023.
Epididymo-orchitis (EO) is a disease of both the epididymis and ipsilateral testis. Brucellar epididymo-orchitis (BEO) is an uncommon localized infection of the testis and epididymis which occurs in about 2-14 % of all patients with brucellosis as a result of urine Brucella removal or due to blood-borne septic metastasis.
Between January 2018 and June 2021, 50 patients with fever, chills, swelling, and pain of the testicle (testicles) were referred to our center. Two approaches were used for the treatment of brucellarepididymo-orchitis among these individuals. Intravenous Gentamicin and Doxycycline were used in seven cases, while Rifampicin was added to this combination for the remaining 43 patients. Intravenous Gentamicin was administered for 7 days and the other drugs were used for 45 days. All patients were followed up for six months by monitoring the symptoms and signs of the disease.
None of the patients had been diagnosed with brucellosis before referral to our clinic. 43 patients were successfully treated by. Intravenous Gentamicin, Doxycycline and Rifampicin, whereas seven patients were fully treated using. Intravenous Gentamicin and Doxycycline. The two therapeutic groups were hospitalized for 7.56 ± 3.45 (3-23) and 10.14 ± 1.77 (8-13) days, respectively. Treatment failure, drug side effects, and disease complications were not observed in any of the cases over a 6-month follow-up period.
Physicians should be alert regarding Brucellarepididymo-orchitis (BEO) within the differential diagnosis of nonspecific epididymo-orchitis, especially in regions where the disease is endemic. Delay in diagnosis or inappropriate management of BEO may result in complications.
附睾炎-睾丸炎（EO）是一种累及附睾和同侧睾丸的疾病。布鲁氏菌性附睾炎-睾丸炎（BEO）是一种罕见的睾丸和附睾局部感染，约占所有布鲁氏菌病患者的2%-14%，其病因是尿液中布鲁氏菌清除或血行性脓毒症转移。
2018年1月至2021年6月，50例出现睾丸发热、寒战、肿胀和疼痛的患者被转诊至我们中心。对这些患者采用了两种方法治疗布鲁氏菌性附睾炎-睾丸炎。7例患者使用静脉注射庆大霉素和多西环素，其余43例患者在此联合用药基础上加用利福平。静脉注射庆大霉素7天，其他药物使用45天。通过监测疾病的症状和体征对所有患者进行了6个月的随访。
在转诊至我们诊所之前，所有患者均未被诊断为布鲁氏菌病。43例患者通过静脉注射庆大霉素、多西环素和利福平成功治愈，而7例患者仅使用静脉注射庆大霉素和多西环素得到充分治疗。两个治疗组的住院时间分别为7.56±3.45（3-23）天和10.14±1.77（8-13）天。在6个月的随访期内，所有病例均未观察到治疗失败、药物副作用和疾病并发症。
在非特异性附睾炎-睾丸炎的鉴别诊断中，医生应警惕布鲁氏菌性附睾炎-睾丸炎（BEO），尤其是在该病流行的地区。BEO诊断延迟或处理不当可能导致并发症。
