Comparison of inflammatory markers between brucella and non-brucella epididymo-orchitis

Abstract

Objectives:Brucellosis is a multi-system infectious disease that is associated with inflammation, which causes an increase in acute phase reactants. Hematological inflammatory markers of brucellosis include mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR). In this study, we aimed to evaluate the diagnostic value of hematological inflammatory markers in Brucella epididymo-orchitis (BEO), and to investigate the utility of these markers for differential diagnosis from non-Brucella epididymo-orchitis (non-BEO).Materials and Methods:We retrospectively reviewed the records of 22 BEO and 50 non-BEO patients. Hematological parameters were recorded and compared between the two groups. The main diagnostic criteria for BEO were positive clinical findings (i.e., testicular pain, tenderness and scrotal swelling), a positive Rose Bengal test result, standard tube agglutination (STA) titer ≥ 1/160, and/or a positive blood culture.Results:The most decisive factors in discriminating between BEO and non-BEO were NLR, RDW, and MPV, in decreasing order of their strength. Regardless of other factors, NLR values < 2.3 significantly increased the odds of BEO (OR=8.080, 95% CI: 1.929-33.843, p=0.004). After adjusting for other factors, RDW values >14.45% significantly increased the odds of BEO (OR=7.020, 95% CI: 1.749-28.176, p=0.006). Independent of the other factors, patients with MPV < 7.65 fL had a 6.336 times higher risk for BEO (95% CI: 1.393 - 28.822, p=0.017).Conclusion:Hematological inflammatory markers such as NLR, RDW, and MPV can aid in the differential diagnosis of BEO and non-BEO.

Direk ve indirek inflamatuar belirteçler Brusella epididimo-orşiti non-Brusella epididimo-orşitten ayırabilir mi?

“…In the current study, the rate of leukocytosis was determined as 54.5% and 71.1% in BEO and NBEO cases, respectively. In addition, similar to the study by Cift et al (13) we found a significantly lower mean WBC count in patients with BEO. In our study, a WBC count of <14.4 had high sensitivity and low specificity for BEO and accurately predicted the diagnosis in 48.9% of cases.…”

“…Although the literature contains studies reporting 10% to 30% rates for leukocytosis in BEO cases, some publications found that this percentage reached 70% (18,20). In their study comparing BEO and NBEO cases, Cift et al (13) noted that the mean WBC count was lower in the former whereas Aydın et al (14) found no difference between the two groups in terms of the mean WBC count. In the current study, the rate of leukocytosis was determined as 54.5% and 71.1% in BEO and NBEO cases, respectively.…”

“…Despite the availability of studies investigating the efficacy of inflammatory markers in various brucellosis cases, the data is not clear due to the conflicting results. In the literature, only two studies evaluated direct and indirect markers in the differentiation of cases diagnosed with BEO and NBEO (13,14).…”

<p>Usefulness of Blood Parameters for Preliminary Diagnosis of Brucellosis</p>

“…More than half a million people are diagnosed with brucellosis every year. 1 After acquiring Brucella, bacteria spread through hematogenous dissemination and affect various organs, such as the urinary, respiratory, central nervous system and cardiovascular. The spread of infection triggers common symptoms of illness, such as fever, nocturnal hyperhidrosis, weight loss, anorexia, arthralgia, and fatigue.…”

“…The spread of infection triggers common symptoms of illness, such as fever, nocturnal hyperhidrosis, weight loss, anorexia, arthralgia, and fatigue. 1,2 This zoonotic disease, which remains a major public and economic health issue in many developing countries, is endemic to the Middle East, South and Central America, the Mediterranean region, and India. 3 Based on reports Iran ranks second in the world in terms of brucellosis and its annual incidence is 98 to 130 people per 100,000 populations.…”