Testicular infection in brucellosis: Report of 34 cases.
J Microbiol Immunol Infect. 2016 Mar 10. pii: S1684-1182
Bosilkovski M1, Kamiloski V2, Miskova S3, Balalovski D4, Kotevska V5, Petrovski M2.
1Medical Faculty “Ss Cyril and Methodius University”, Skopje, Macedonia. Electronic address: email@example.com
2Medical Faculty “Ss Cyril and Methodius University”, Skopje, Macedonia.
3Department for Infectious Diseases, Medical Center, Veles, Macedonia.
4Department for Infectious Diseases, Medical Center, Bitola, Macedonia.
5Medical Faculty “Ss Cyril and Methodius University”, Skopje, Macedonia; Institute for Clinical Microbiology, Skopje, Macedonia.
To present clinical and laboratory features, treatment options, and outcome in patients with brucellar testicular infection and to compare them with analogous in brucellar patients without testicular involvement.
Thirty four brucellar patients with testicular infection treated in two general hospitals in the Republic of Macedonia, during the period 1998-2009, were retrospectively analyzed. Their clinical and laboratory characteristics were compared with analogous in 364 male brucellar patients without testicular infection, who were treated at the same hospitals during the same time period.
Brucellar testicular infection was evident in 34 (8.5%) out of 398 male patients with brucellosis. The median age of the patients was 46.5 years. In all patients testicular involvement was presented as an acute form with a median duration of 5 days (range, 2-14 days) prior to diagnosis. Twenty-three of the patients had at least one other simultaneous focal infection. After starting with the treatment testicular infection lasted a median 10 days, range 7-21 days. Brucellar patients with testicular infection when compared with other brucellar patients more frequently manifested fever (97% vs. 61%), concomitant spondylitis (32% vs. 16%), and urinary system involvement (12% vs. 2%). Also, the relapse rate in patients with testicular involvement was significantly higher (24% vs. 9%).
In endemic regions brucellosis should be taken into consideration in any patient with testicular infection. Brucellar testicular involvement is usually characterized with a severe acute clinical presentation and a high percentage of relapses which entails the need of timely recognition and proper treatment duration of at least 60 days.