Hamoda Taha Abo-Almagd Abdel-Meguid, Bahassan Omar, Almalki Abdullah Majed, Alkhzaim Ali Hasan, Khogeer Ahmed Nizar, Ahmed Ehab Mahmoud, Algarni Kamal
Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Urology, Minia University, El-Minia, Egypt.
Urol Ann. 2023 Jul-Sep;15(3):340-348. doi: 10.4103/ua.ua_129_22. Epub 2023 Jul 17.
Brucellosis is an endemic zoonotic disease caused by intracellular gram-negative coccobacilli called . This infectious disease may implicate many farm animals and is transmissible to exposed humans. Brucellosis is potentially life-threatening and may lead to granulomatous multi-organ involvement with tendency to chronicity and recurrence. The treatment of brucellosis requires combined and protracted antimicrobial therapies to eliminate the disease and to avoid its relapse. Genitourinary brucellosis is common among infected humans in endemic areas and is considered the second-most affected focal site, which commonly manifests as epididymo-orchitis. Testicular abscess, however, is an extremely rare complication of brucellosis. To the best of our knowledge, in the literature, there are to date only 16 previously published case reports, including 22 patients of brucellar testicular abscesses, emphasizing the extreme rarity of this condition. Most of these cases harbored small abscesses, which were treated conservatively using antibiotics therapy only, or with added drainage of the abscesses. Larger abscesses were reported to necessitate orchiectomy. In some cases, the abscesses were mimicking tumors, and surgeries for orchiectomy were done accordingly. A summary of the previously reported cases in the literature is presented. Here, we present the 17 case report of a 34-year-old man with a right-side huge multilocular brucellar testicular abscess apparently replacing the entire testicle, who was successfully treated with organ-sparing management by incision-drainage of the large abscess with antibiotics, to eventually preserve his testis. In conclusion, brucellosis should be considered among the differential diagnoses of any testicular swelling, especially in endemic areas. Drainage of brucellar testicular abscess with appropriate medical treatment is feasible and may preserve the testicle, even with large abscess apparently replacing the entire testicle.
布鲁氏菌病是一种由称为布鲁氏菌的细胞内革兰氏阴性球杆菌引起的地方性人畜共患病。这种传染病可能累及许多农场动物，并可传染给接触者。布鲁氏菌病有潜在的生命危险，可能导致肉芽肿性多器官受累，并有慢性化和复发倾向。布鲁氏菌病的治疗需要联合且长期的抗菌治疗，以消除疾病并避免复发。泌尿生殖系统布鲁氏菌病在流行地区的感染者中很常见，被认为是第二大受影响的病灶部位，通常表现为附睾炎或睾丸炎。然而，睾丸脓肿是布鲁氏菌病极为罕见的并发症。据我们所知，在文献中，迄今为止仅有16篇先前发表的病例报告，包括22例布鲁氏菌性睾丸脓肿患者，强调了这种情况的极端罕见性。这些病例中的大多数有小脓肿，仅使用抗生素治疗或加用脓肿引流进行保守治疗。据报道，较大的脓肿需要进行睾丸切除术。在某些情况下，脓肿类似肿瘤，因此进行了睾丸切除手术。本文呈现了文献中先前报道病例的总结。在此，我们报告一例34岁男性患者的病例，其右侧有一个巨大的多房性布鲁氏菌性睾丸脓肿，明显取代了整个睾丸，通过切开引流大脓肿并联合抗生素进行器官保留治疗，最终成功保留了他的睾丸。总之，对于任何睾丸肿胀的鉴别诊断都应考虑布鲁氏菌病，尤其是在流行地区。布鲁氏菌性睾丸脓肿通过适当的药物治疗进行引流是可行的，即使大脓肿明显取代了整个睾丸，也可能保留睾丸。
