Comparison of brucella and non-specific epididymorchitis: gray scale and color Doppler ultrasonographic features

Ozturk, Adil; Öztürk, Ebru; Zeyrek, Fadile Yıldız; Onur, Kahraman; Sirmatel, Ocal; Kat, Nurcan

doi:10.1016/j.ejrad.2005.01.008

Cited by 20 publications

(15 citation statements)

References 26 publications

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“…In addition, no seasonal pattern was noticed, while we found leukocytosis in 5/17 patients, different from what was reported by Crosby et al [21]. In our study, only 7/17 patients presented scrotal ultrasonographic findings that could attributed to BEO, while Ozturk et al reported as high as 82% (14). We think that ultrasonography is more useful in enabling exclusion of the possibility of abscesses or tumors than it is in helping to establish the primary clinical diagnosis.…”

Section: Discussioncontrasting

confidence: 56%

“…Since they were not hospitalized and therefore not promptly investigated, they might have been misdiagnosed as non-specific epididymo-orchitis. Both clinical and radiological characteristics of BEO have been previously reported [14,15]. Seasonal pattern, gradual onset, long duration, typical undulatory fever, absence of serious leukocytosis and lower urinary tract symptoms, and relatively minimal local signs of florid inflammation poses a clinical suspicion of BEO, while heterogenicity, focal echogenicity differences and hydrocele with granularity and/or septation on scrotal ultrasound raise the possibility of BEO rather than non-specific epididymo-orchitis.…”

Section: Discussionmentioning

confidence: 99%

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Brucella melitensis: a rarely suspected cause of infections of genitalia and the lower urinary tract

Stamatiou¹,

Polyzois²,

Dahanis³

et al. 2009

Braz J Infect Dis

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We examined the clinical presentation and outcome of Brucellar infections of genitalia and the lower urinary tract through a review of the medical records of 10 cases of male patients with brucellar infections of the genitalia and lower urinary tract. The mean age of the patients with brucellosis was 49.2, (median 52, range 15-77 years). Eleven out of 17 patients were rural residents, 15 reported that they might have consumed unpasteurized dairy products) and four reported occupational exposure. Symptoms onset was acute in almost all cases. Scrotal pain, epidedimal swelling and fever were the most common symptoms. The Wright test was positive in 13 patients, while Brucella sp. was isolated from blood cultures in six cases. Only two patients were found with abnormal liver ultrasonography. All patients underwent treatment with doxycycline and aminoglycoside for seven days and doxycycline alone for two months. Most of them responded to antibiotic therapy with rapid regression of symptoms. One patient failed to respond to therapy and presented necrotizing orchitis, as well as abscesses, which required orchectomy. Brucellar infections of the genitalia and lower urinary tract have no specific clinical presentation; the usual laboratory examination is not sufficient to diagnose this kind of infection, therefore it could easily be misdiagnosed. An analytical medical history (including overall dietary habits and recent consumption of non-pasteurized dairy products) could indicate Brucelosis as would the persistence of symptoms despite a one-week antibiotic treatment. In general, patients afflicted by brucellar epididymoorchitis respond to Brucellosis antibiotic therapy, except for some rare cases that present necrotizing orchitis and require surgical treatment.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Brucella melitensis: a rarely suspected cause of infections of genitalia and the lower urinary tract

Stamatiou¹,

Polyzois²,

Dahanis³

et al. 2009

Braz J Infect Dis

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“…In a comparison study performed by Öztürk et al on 28 patients with BEO and 28 patients with NEO using gray-scale and color Doppler USG, internal echo, scrotal skin thickness, testicular heterogeneity, and focal hypoechoic testicular area(s) findings were statistically significantly higher in patients with BEO (24). Similarly, focal hypoechoic testicular area(s) and testicular heterogeneity were the most frequent findings in our cases.…”

Section: Discussionmentioning

confidence: 86%

“…USG is a valuable method for ruling out noninfectious causes and diagnosing BEO (14,24,25). In a comparison study performed by Öztürk et al on 28 patients with BEO and 28 patients with NEO using gray-scale and color Doppler USG, internal echo, scrotal skin thickness, testicular heterogeneity, and focal hypoechoic testicular area(s) findings were statistically significantly higher in patients with BEO (24).…”

Section: Discussionmentioning

confidence: 99%

The clinical and laboratory characteristics, treatments, and outcomes of patients with Brucella epididymo-orchitis (BEO) compared to those without BEO*

Naz¹,

Korkmaz²,

Çevik³

et al. 2016

Turk J Med Sci

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IntroductionBrucellosis is a frequently encountered zoonosis in various regions of the world, including the Mediterranean region (1). The number of reported cases each year is about 500,000, but this number is lower than the real incidence (2). It is endemic in some regions of Turkey, especially in the Central Anatolian region (3). Although the mortality from brucellosis is low, the disease continues to be a major public health problem because of the high morbidity (4).The disease usually presents as fever with no apparent focus, although focal forms are present in 20% to 40% of cases (5). The reproductive system is the second most common site of focal brucellosis. Brucellosis can present as epididymo-orchitis (EO) in men and it is often difficult to differentiate brucellosis from other local diseases (6).In our study, we aimed to describe the clinical and laboratory characteristics, treatment, and final outcomes of 21 patients with Brucella epididymo-orchitis (BEO) from our hospital in Turkey. Materials and methodsA total of 21 patients with EO due to brucellosis, who were diagnosed between June 2001 and June 2013 and treated at Eskişehir Yunus Emre State Hospital, located in the city of Eskişehir in the Central Anatolia region of Turkey, were evaluated retrospectively. The history, physical examination, routine laboratory, and microbiology and radiology test results were evaluated.Diagnosis was made by clinical symptoms together with the following laboratory test results: titer of >1:160 in the standard tube agglutination test (STA), and/or isolation of Brucella species from blood and other bodily fluids or tissues. Patients with a titer of ≥1:160 in the STA, and those with lower titers but showing a 4-fold increase in 2 weeks' time, were considered to be positive. Brucella abortus antigens were used in the STA test. Rose-Bengal test (RBT) positivity was checked twice with the STA test.For the cultures, a standard blood culture system consisting of biphasic brain-heart infusion medium was Background/aim: We aim to describe the clinical and laboratory characteristics, treatment, and outcomes of 21 patients with Brucella epididymo-orchitis (BEO) from Eskişehir Yunus Emre State Hospital, Turkey. Materials and methods:A total of 21 patients with BEO who were diagnosed and followed in the Infectious Diseases Clinic between June 2001 and June 2013 were evaluated retrospectively.Results: One hundred and twenty-eight of 192 patients evaluated throughout the study were male and BEO was determined in 21 (16.4%) patients. A total of 18 (85.7%) patients had a titer of ≥1:160 in standard agglutination test (STA). Three patients with STA <160 were diagnosed by blood culture. When all the male patients were evaluated in terms of demographic, clinical, and laboratory findings, animal contact, rural living, and subacute clinical type were statistically significantly higher in the group that developed epididymoorchitis. None of the patients underwent surgery after medical treatment, but due to a delay in diagnosis of brucellosis...

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“…Key diagnostic features are the suspicion of having contracted brucellosis by living in or visiting an endemic area, the relatively recent ingestion of unpasteurized milk or products, a typical fever, and the results of clinical findings and specific serologic tests for brucellosis. 5,8,[16][17][18] In patients with a testicular brucellar abscess described in the literature, orchiectomy has been performed unnecessarily because of tumorlike appearance of small lesions in the early period, and it has been performed consistently in patients with a delayed diagnosis because of large suspicions lesions that have caused partial or total destruction of the testis. In most patients, both surgical intervention and combined antibiotic treatment are required.…”

Section: Discussionmentioning

confidence: 98%

Gonadal brucellar abscess: Imaging and clinical findings in 3 cases and review of the literature

Koç

Turunç

Boğa

2007

J of Clinical Ultrasound

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We report the cases of 3 patients with brucellar gonadal abscess who were examined with gray-scale and color Doppler sonography. In these 3 cases, sonography revealed a thick-walled avarian (n = 2) or testicular (n = 1) abscess. Duplex Doppler sonography indicated a low-resistance type of flow in all 3 patients. The diagnosis of brucellar gonadal abscess is difficult, because it may have a misleading tumor-like appearance. Awareness of the imaging findings of gonadal abscess in patients with brucellosis and correlation with the results of serologic testing can allow early diagnosis, especially in endemic areas.

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Comparison of brucella and non-specific epididymorchitis: gray scale and color Doppler ultrasonographic features

Cited by 20 publications

References 26 publications

Brucella melitensis: a rarely suspected cause of infections of genitalia and the lower urinary tract

Brucella melitensis: a rarely suspected cause of infections of genitalia and the lower urinary tract

The clinical and laboratory characteristics, treatments, and outcomes of patients with Brucella epididymo-orchitis (BEO) compared to those without BEO*

Gonadal brucellar abscess: Imaging and clinical findings in 3 cases and review of the literature

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