An unusual complication of a common endemic disease: Clinical & laboratory aspects of patients with brucella epididymoorchitis in north of Iran

Department of infectious disease, North Iranian tropical and infectious disease research center, Mazandran university of medical sciences, Iran. .
BMC Research Notes 08/2011; 4(1):286. DOI: 10.1186/1756-0500-4-286
Source: PubMed


Brucella epididymoorchitis(BEO) is a focal complication of human brucellosis and has been reported in 2-20% of patients with brucellosis. Brucellosis is an endemic disease in Iran. The incidence of the disease in this country is 34 per 100 000 per year.
In a retrospective study, we identified 30 cases of Brucella epididymoorchitis in two teaching hospitals in the north of Iran during 1997-2009.
Epididymoorchitis occurred in 11.1% of male patients with brucellosis. The average age was 25.5 ± 12.43 years. Pain and scrotal swelling (100%) and fever (96.7%) were the most common symptoms. Different treatment regimens were administered including doxycycline plus rifampin (60%), doxycycline plus rifampin plus aminoglycoside for the first two weeks (36.6%) and doxycycline plus cotrimoxazole(3.4%). Ten percent of the patients did not respond to antibiotic therapy and required surgical drainage or orchiectomy.
In brucellosis endemic areas, clinicians who encounter patients with epididymoorchitis should consider the likelihood of brucellosis. A careful history and physical examination and an immediate laboratory evaluation help to make a correct diagnosis. Generally, classical therapy of brucellosis is adequate for the treatment of epididymoorchitis.

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    • "The highest annual incidence rates are reported from the Middle Eastern countries, such as Syria, Iraq, Iran, and Saudi Arabia (Pappas et al., 2006). In Iran, where Brucellosis is endemic, the incidence of the disease is up to 34 per 100,000 per year in certain areas (Najafi et al., 2011). "
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    ABSTRACT: Brucellosis is an important zoonotic disease with a worldwide distribution. Despite its control in many countries, it remains endemic in Iran. Routine serological surveillance along with high clinical suspicion and screening of family members of index cases would be essential in delineating the real magnitude of human brucellosis in endemic countries. Laboratory testing is indispensable for diagnosis. Advances in newer rapid, sensitive, and specific testing methodologies and alternate treatment strategies are urgently needed. A safe and effective vaccine in human is not yet available. Prevention is dependent upon increasing public awareness through health education programs and safe livestock practices. Co-operation between health and veterinary services should be promoted actively .This review contains all these issues in general, and the incidence, diagnosis and therapy in particular, in the Iran.
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