Brucella orchitis presenting as a testicular mass mimicking a testicular tumor: a rare case report

Abstract

Introduction Brucella epididymo-orchitis is a complication that occurs in 5.7% of patients with brucellosis and can rarely mimic a testicular tumor. We here report a case of a 25-year-old man with a testicular brucellosis that presented as a testicular mass that responded to conservative treatment using antibiotic therapy. Case report A 25-year-old patient presented with left testicular pain, abdominal pain, easy fatiguability, and feeling unwell. Physical examinations were normal. A testicular tumor was suggested by a scrotal color Doppler US scan and testicular MRI. However, tumor markers were all within the normal range. A serum Brucella agglutination test (Rose Bengal test) was done, and it was positive. The patient received anti-brucella antibiotics. An ultrasound scan 3 months later revealed complete recovery after completing antibiotic treatments. Discussion Brucella orchitis can be determined based on the triad of serology, ultrasonography, and the presence of the common symptoms like fever, testicular pain, redness, and enlargement. The early diagnosis of this phenomenon is crucial due to the morbidity and complications that may be encountered. Moreover, it has several differential diagnoses, such as testicular tumor, epididymitis, trauma, torsion of the testis, and hematocele. Failure to obtain an adequate diagnosis, particularly if a testicular tumor is suspected, may result in unnecessary intervention like orchiectomy. Conclusion Brucella orchitis is a complication of brucella infection that may mimic a testicular tumor. Several techniques of diagnosis are required for an accurate assessment.

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

“…These features can also be seen in other etiologies of orchitis. Thus, the U/S examination cannot be relied on solely for the diagnosis of BEO (1,9). All these features could be seen in the U/S examination of our cases, of which vascularity was the most prevalent finding (91%).…”

“…Regarding the incidence of BEO in patients with brucellosis, it has been reported to occur in 2% to 20% of the cases (1). In their study, Ultrasonography is usually vital for excluding the suspicion of an abscess or tumor rather than confirming the primary diagnosis.…”

“…This raises a noteworthy concern, as brucellosis could potentially exert adverse effects on the reproductive outcomes of sexually active young adults (9). In around 20-40% of cases, Brucella orchitis is considered to stem directly from epididymitis (1). A study by Baykan et al found that approximately 67% of 24 male cases showed involvement of both the epididymis and testes (21).…”

“…All these features could be seen in the U/S examination of our cases, of which vascularity was the most prevalent finding (91%). It has been indicated that using medications like rifampicin, streptomycin, tetracycline, ciprofloxacin, doxycycline, and cotrimoxazole for at least six weeks has a significant impact on managing brucellosis (1). A suggested approach involves taking a daily combination of doxycycline (200 mg) and rifampicin (600 mg) for around six weeks.…”

“…The major sources of infection are dogs, sheep, cattle, goats, swine, camels, and reindeer. Human infection can occur through direct contact, inhalation of the microbe, consumption of contaminated meat, or ingestion of unpasteurized milk (1,2). Millions of people globally are at risk Brucella epididymo-orchitis: A single-center experience with a review of the literature secutive BEO patients diagnosed and treated at the urology clinic of Smart Health Tower (SHT) between January 2021 and January 2023.…”