Brucellar epididymo-orchitis: Symptoms, diagnosis, treatment and follow-up of 50 patients in Iran

Brucellosis in hospitalized patients and their animals in the agro-pastoral region of Theniet El Had (Algeria) during ten years (2013-2023)

Introduction

Brucellosis is an important zoonosis problem worldwide. It's also recognized as a clinical and health problem in Algeria.

Methods

This research is a descriptive study to determine the prevalence of brucellosis and some clinical and epidemiological aspects of hospitalized patients in the agro-pastoral region of Theniet El Had for ten years, between March 2013 and March 2023. During the study period, 180 patients (61.66% men and 38.33% women) with confirmed brucellosis based on clinical symptoms and serological tests were hospitalized for treatment. Patients working with animals were requested to screen their animals (383 goats from 27 suspicious farms with no history of vaccination), 16, 71% of goats from 44%, and 44% herds were infected.

Results

The occurrence of human cases varied from 49.18 to 66.02pcm (cases/100,000 inhabitants) with an average of 58, 48pcm (cases/100,000 inhabitants). Almost half of hospitalized people who had been in contact with animals could have been contaminated by direct contact. Consumption of unpasteurized dairy products during the last 2 months was at the order of 95.55%. A family history of Brucellosis was observed in 36 (20%) patients. Brucella epididymo-orchitis occurred in 18.01% while relapse occurred in a small proportion of 7.22%.

Conclusions

Local authorities should prevent human brucellosis with surveillance systems, disease declarations, biosecurity programs, and warning communities about the hazards of consumption of unpasteurized milk and dairy products.

Brucella epididymo-orchitis: A single-center experience with a review of the literature

Brucella epididymo-orchitis (BEO) is a rare complication of brucellosis. Despite the high incidence of brucellosis in developing countries, few case series on BEO are available. This study focuses on the clinical presentations, diagnosis, and treatment of BEO with a review of the literature. This study included consecutive BEO patients diagnosed and treated at Smart Health Tower between 2021 and 2023. The required data were retrospectively collected from patients' profiles. The BEO diagnosis was established through scrotal Doppler ultrasound in cases with a positive Rose Bengal test and positive IgG and IgM results for brucellosis, in addition to scrotal pain and swelling. This study included 11 cases whose ages ranged from 22 to 55 years. Most of the cases presented with testicular pain (72.7%), followed by fever (63.6%) and arthralgia (63.6%). The right side (54.5%) was slightly more affected than the left side (45.5%). The major abnormal laboratory finding was an elevated C-reactive protein (82%). The treatment was conservative, in which a combination of gentamicin, doxycycline, and rifampicin was administered to the patients for about 6-8 weeks. One case underwent an orchiectomy due to the abscess formation. All the patients responded well to the treatment, with no recurrence. In the Middle East, brucellosis remains a concerning infectious disease. Early diagnosis, aimed at preventing abscess formation and other complications, takes first priority to avoid invasive interventions.