Epididymoorchitis due to Brucella mellitensis: A retrospective study of 59patients

Epididymoorchitis is a focal form of human brucellosis described in 2%-20% of patients with brucellosis. We assessed 59 cases of Brucella epididymoorc hitis (BEO) between 1991 and 1999. The median age of patients was 34 years (range, 15-75 years). The onset of symptoms was acute in 46 patients (78%). Scrotal pain and swelling (100% of patients), fever (88%), and sweating (7 3%) were the most common symptoms. Brucella species was isolated from blood cultures in 41 patients (69%) and from epididymal aspiration in 4 patients . Treatment consisted of a combination of a doxycycline and an aminoglycosi de (n= 39) or rifampin ( n = 10); trimethoprim-sulfamethoxazole with rifamp in (n = 3); or trimethoprim-sulfamethoxazole as monotherapy (n = 7). The me dian duration of therapy was 45 days (range, 21-90 days). The infections of 9 patients (15%) failed to respond to therapy, and 15 patients relapsed (2 5%). Three patients with necrotizing orchitis whose infections were unrespo nsive to antibiotics required an orchiectomy. In general, classical brucell osis therapy is adequate for BEO.