Brucellar Orchitis in Innerwest Anatolia Region of Turkey

Kadıköylü, Gürhan; Tuncer, Günay Ertem; Bolaman, Zahit; Sina, Muhammed

doi:10.1159/000064357

Cited by 20 publications

(25 citation statements)

References 5 publications

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“…12,14,15 However, the present study is the first report in Ecuador with B. abortus as the causative agent. Usually, brucellosis-related epididymo-orchitis is unilateral, 12,[16][17][18][19] but bilateral infections have been reported.…”

Section: Discussionmentioning

confidence: 59%

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First Report of Orchitis in Man Caused by Brucella abortus Biovar 1 in Ecuador

Ron-Román¹,

Saegerman²,

Minda-Aluisa³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. We present a 44-year-old man from a rural community in northern Ecuador who worked on a cattle farm where he was involved with primary veterinary care, including assistance during births (or calving) and placenta retention and artificial insemination, with minimal precautions. In September of 2009, quite abruptly, he developed asthenia and hypersomnia without any apparent cause or symptoms like fever, chills, or night sweats. On November 14, 2009, he suffered from pain and edema in the right testicle that coincided with pain in the abdomen. Clinical, serological, and bacteriological investigations confirmed the first case of unilateral orchitis in man in Ecuador caused by Brucella abortus biovar 1. Because brucellosis is a neglected disease, special attention should be given to it in the training of medical and veterinary students.

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Section: Discussionmentioning

confidence: 59%

“…24 Several works have promoted leucocytosis as an indicator to differentiate epididymo-orchitis caused by Brucella spp. 14,15,18,20,[25][26][27] from non-specific orchitis, but it was not observed in this case. In non-specific orchitis, signs of inflammation are very clear (i.e., dermatitis of the scrotal skin).…”

Section: Discussionmentioning

confidence: 75%

First Report of Orchitis in Man Caused by Brucella abortus Biovar 1 in Ecuador

Ron-Román¹,

Saegerman²,

Minda-Aluisa³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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“…In addition, there are case reports, or reports of single cases within larger studies, that offer some data regarding the use of quinolones as alternatives to standard treatment when the latter causes toxicity to the patients (14,16,19). Also, successful treatment of relapse of brucellosis by the use of quinolone-based regimens, in cases where standard treatments failed, has been described (28,43). Finally, there are promising reports regarding the use of a quinolone as the third agent in therapeutic combinations for complicated and difficult-to-treat cases of brucellosis (2,40,63,64,66).…”

Section: Clinical Studiesmentioning

confidence: 99%

“…First, they may replace a tetracycline or rifampin whenever toxicity of one of these two agents occurs when they are administered in combination therapy. Moreover, there is a rationale, as well as some evidence, for using quinolones as part of a second-line regimen in patients who fail to respond or develop disease relapse after therapy with a nonquinolone regimen (28,43). Also, there are anecdotal reports of promising clinical results when quinolones are used in complicated brucellosis as a third treatment agent in combination therapy.…”

Section: Critical Evaluation Of the Available Evidencementioning

confidence: 99%

Quinolones for Treatment of Human Brucellosis: Critical Review of the Evidence from Microbiological and Clinical Studies

Falagas

Bliziotis

2006

Antimicrob Agents Chemother

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3Brucellosis is a zoonotic disease with worldwide distribution that is endemic in the Mediterranean region, the Middle East, Central Asia, and parts of Africa and Latin America. Worldwide, brucellosis remains a major cause of morbidity in humans and domesticated animals. In animals, bovine brucellosis, caused mainly by Brucella abortus, is still the most widespread form. In humans, ovine/caprine brucellosis caused by Brucella melitensis is by far the most common type of disease. The disease has a wide spectrum of clinical manifestations and can affect a variety of organs and systems. Localized and complicated forms of brucellosis cause important morbidity and require prolonged medical treatment. Fortunately, mortality is relatively low and is related mainly to cardiovascular and central nervous system complications of the disease.Although several studies have been conducted over the past 2 decades, there is no conclusive evidence on the optimum antibiotic therapy for brucellosis. Disease relapse still represents one of the most important therapeutic problems. The last recommendation by the World Health Organization (WHO) for the treatment of acute brucellosis in adults was published in 1986 and suggested 600 to 900 mg rifampin and 200 mg doxycycline daily for a minimum of 6 weeks (8). Alternatively, the WHO suggested that rifampin could be replaced with 15 mg/kg of streptomycin, administered intramuscularly for only 2 weeks. However, a meta-analysis, as well as a prospective randomized trial, both performed by Solera et al., showed that the "good old" combination regimen of streptomycin with an oral tetracycline results in fewer relapses than the doxycycline-rifampin combination (57, 58). Controlled clinical trials with other antibiotics, including trimethoprim-sulfomethoxazole, new macrolides, and ␤-lactams, have shown inferior results or involved too few patients for a proper evaluation. Thus, the most widely used regimens are the two aforementioned combinations that were recommended by the WHO. In addition, rifampin monotherapy is the main option for brucellosis during pregnancy, whereas its combination with trimethoprim-sulfomethoxazole is the suggested treatment for childhood brucellosis (5, 34).Certain focal forms of brucellosis are difficult to treat, and surgery should be considered for patients with endocarditis or cerebral, epidural, splenic, or other abscesses (20, 41). Regarding medical treatment, although the antibiotics used are essentially the same, prolonged therapy, up to six or more months, may be needed for patients with osteoarticular forms of the disease, and especially spondylitis (18,56,65). Also, tripleantibiotic combinations were found to be of value in some case series of brucellar endocarditis, spondylitis, and meningitis (2, 41, 65). Relapse of the disease also represents a major therapeutic problem for its focal forms.Since the mid 1980s, laboratory researchers and clinicians have performed several microbiological and clinical studies of the possible use of quinolones in the treatmen...

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“…The most frequent genitourinary complication of brucellosis is EO, affecting 2-20% of males with brucellosis, [10][11][12] and it was first described by Hardy as a cause of granulamatous orchitis in 1928. 13,14 The testes or epididymis is infiltrated with lymphocytes and plasma cells, and there is an atrophy of the seminiferous tubules. 8 Although the prognosis of brucellar epididymo-orchitis (BEO) is usually good, delay in diagnosis or inappropriate management may result in serious complications, such as testicular abscess, which may require orchiectomy.…”

Section: Introductionmentioning

confidence: 99%

Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience

Çelen¹,

Ulug²,

Ayaz³

et al. 2010

Braz J Infect Dis

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Objective: the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO) reporting to the reference hospital in Southeastern Anatolia of Turkey. Material and methods: in this study, 27 male patients with brucellosis, who presented with epididymitis or epididymo-orchitis (EO) at the university hospital in Diyarbakir from 1998 to 2006, were included. They were compared with the other male patients. Positive blood culture or high agglutination titers of ≥ 1/160 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Results: fourteen patients had unilateral EO. Leukocytosis was present in 10 patients; all of them had initial agglutination titers of ≥ 1/160 and 10 patients had a positive blood culture. All patients received combined therapy with streptomycin for the first 21 days (or oral rifampicin for 6-8 weeks) with doxycycline or tetracycline for 6-8 weeks. All showed improvement, fever subsided in 3-7 days, and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year. Conclusion: in brucellosis-endemic areas, clinicians encountering EO should consider the likelihood of brucellosis. In this study, young age was the most common risk factor, and leukocytosis and high CRP level were the most common laboratory findings. Most cases were unilateral. All patients responded to medical management very well. Conservative management with combination antibiotic therapy was adequate for managing BEO. Conclusively, brucellosis must be considered as a cause of orchitis, especially in endemic regions like Turkey.

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Brucellar Orchitis in Innerwest Anatolia Region of Turkey

Cited by 20 publications

References 5 publications

First Report of Orchitis in Man Caused by Brucella abortus Biovar 1 in Ecuador

First Report of Orchitis in Man Caused by Brucella abortus Biovar 1 in Ecuador

Quinolones for Treatment of Human Brucellosis: Critical Review of the Evidence from Microbiological and Clinical Studies

Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience

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