Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis.
Links Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis. Colmenero JD, Munoz-Roca NL, Bermudez P, Plata A, Villalobos A, Reguera JMDiagn Microbiol Infect Dis. 2006 Nov 30; [Epub ahead of print] Links Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis. Colmenero JD, Munoz-Roca NL, Bermudez P, Plata A, Villalobos A, Reguera JM. Infectious Diseases Service, Carlos Haya University Hospital, 29010 Malaga, Spain. We have studied 912 patients with brucellosis. Of these, 631 (69.2%) were male and 48 had epididymo-orchitis, giving an incidence of epididymo-orchitis of 7.6%. The duration of symptoms before diagnosis was 52.5 +/- 70 days. All the patients had fever, swelling, and scrotal pain, but only 2 (4.2%) reported urinary symptoms. Seven patients (14.5%) had leukocyte figures above 11 x 10(9)/L, and urine analysis was normal in 69% of the patients. Blood cultures were positive in 65.8% of cases. A total of 33 patients (68.8%) received a combination of doxycycline plus streptomycin and 13 (27.1%) doxycycline plus rifampin. The overall percentage of failure or relapse was 8.8%: 7.1% in the doxycycline plus streptomycin group and 20% in the doxycycline plus rifampin group. None of the patients required surgery. Pending clinical trials to confirm the results, conservative management with a combination of doxycycline for 2 months and streptomycin for 14 to 21 days appears to be adequate and could avoid unnecessary orchiectomy. PMID: 17141451 [PubMed - as supplied by publisher] Related Links Brucellar epididymo-orchitis in Saudi Arabia: a retrospective study of 26 cases and review of the literature. [BJU Int. 2001] PMID: 11446850 Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus streptomycin. A randomized, double-blind study. [Ann Intern Med. 1992] PMID: 1596044 Endemic brucellar epididymo-orchitis: a 10-year experience. [Int J Infect Dis. 2002] PMID: 12718826 Comparative trial of rifampin-doxycycline versus tetracycline-streptomycin in the therapy of human brucellosis. [Antimicrob Agents Chemother. 1985] PMID: 4073878 Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas. [Antimicrob Agents Chemother. 1995] PMID: 8540716 See all Related Articles... Display Summary Brief Abstract AbstractPlus Citation MEDLINE XML UI List LinkOut ASN.1 Related Articles Cited Articles Cited in Books CancerChrom Links Domain Links 3D Domain Links GEO DataSet Links Gene Links Gene (GeneRIF) Links Genome Links Project Links GENSAT Links GEO Profile Links HomoloGene Links Nucleotide Links Nucleotide (RefSeq) Links OMIA Links OMIM (calculated) Links OMIM (cited) Links BioAssay Links Compound Links Compound via MeSH Substance Links Substance via MeSH PMC Links Cited in PMC PopSet Links Probe Links Protein Links Protein (RefSeq) Links SNP Links Structure Links Taxonomy via GenBank UniGene Links UniSTS Links Show 5 10 20 50 100 200 500 Sort by Pub Date First Author Last Author Journal Send to Text File Printer Clipboard E-mail Order .
Infectious Diseases Service, Carlos Haya University Hospital, 29010 Malaga, Spain.
We have studied 912 patients with brucellosis. Of these, 631 (69.2%) were male and 48 had epididymo-orchitis, giving an incidence of epididymo-orchitis of 7.6%. The duration of symptoms before diagnosis was 52.5 +/- 70 days. All the patients had fever, swelling, and scrotal pain, but only 2 (4.2%) reported urinary symptoms. Seven patients (14.5%) had leukocyte figures above 11 x 10(9)/L, and urine analysis was normal in 69% of the patients. Blood cultures were positive in 65.8% of cases. A total of 33 patients (68.8%) received a combination of doxycycline plus streptomycin and 13 (27.1%) doxycycline plus rifampin. The overall percentage of failure or relapse was 8.8%: 7.1% in the doxycycline plus streptomycin group and 20% in the doxycycline plus rifampin group. None of the patients required surgery. Pending clinical trials to confirm the results, conservative management with a combination of doxycycline for 2 months and streptomycin for 14 to 21 days appears to be adequate and could avoid unnecessary orchiectomy.
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