Brusellozun ilk manifestasyonu olarak ortaya çıkan epididimo-orşit olgularının semptom ve bulguları non-spesifik epididimo-orşitten farklı mıdır?

Abstract

Bruselloz, hayvanlardan insanlara bulaşan, çeşitli doku ve organları tutan, hafif belirtilerden ağır klinik tablolara kadar seyredebilen, belirti ve bulguları spesifik olmayan ve bu nedenlerle birçok hastalığı taklit edebilen sistemik bir hastalıktır. Dünya Sağlık Örgütü (DSÖ) verilerine göre dünyada en sık rastlanan bakteriyel zoonoz olan bruselloz ABSTRACT OBJECTIVE: Brucella epididymo-orchitis as the first presenting sign of brucellosis (BEO) is difficult to separate from non-specific epididymo-orchitis (NSEO). In these cases, delayed diagnosis and treatment causes testicular damage that may lead to infertility and orchiectomy. The aim of this study was to investigate whether or not the clinical, laboratory and radiological findings of BEO different from NSEO. MATERIAL and METHODS: In this retrospective study, we evaluated the medical records of 164 patients who diagnosed with epididymo-orchitis in our clinic between January 2010 and June 2018. The diagnosis of epididymo-orchitis was based on clinical and laboratory findings and ultrasonographic examination. High agglutination titers (≥1/160) and/or positive blood cultures were accepted as the main criteria for the diagnosis of brucellosis. Five patients who were previously diagnosed as brucellosis were excluded from the study and the clinical, laboratory and radiological findings of 9 cases of BEO were compared with 34 NSEO cases in the same age group. RESULTS: The mean age of cases at diagnosis was 33.44±9.81 and 34.76±10.09 in the BEO and NSEO groups, respectively (p=0.728). There were no significant differences between two groups in terms of clinical, laboratory and radiological findings, except one. Risk factors for brucella were detected in 8 (88.9%) of BEO group and in 5 (14.7%) of NSEO group (p<0.001). Although not statistically significant but at the level of borderline significant trend, it was found that the ratio of arthralgia and serum CRP levels >5 mg/dL more frequent in BEO group and the ratio of dysuria, pyuria and leukocytosis more frequent NSEO group (p values 0.073, 0.089, 0.069, 0.069 and 0.058, respectively). CONCLUSION: Brucellosis should be kept in mind in patients with epididymoorchitis and the risk factors for brucellosis should be questioned in these patients. In addition, in patients with epididymo-orchitis with arthralgia without dysuria, pyuria and leukocytosis should more be paid attention to the differential diagnosis of BEO.