tetracycline and Orchitis

To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously.. In this retrospective study, records of all 26 adult patients with brucellosis, who presented with epididymitis or epididymo-orchitis at a tertiary hospital in Riyadh from 1983 to 2000, were reviewed. Positive blood culture or high agglutination titres of > or = 1 : 320 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Among these cases, epididymitis or epididymo-orchitis was diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis.. Epididymo-orchitis occurred in 1.6% of all patients with brucellosis. Most (58%) were 25--44 years old; approximately 77% of the patients presented with acute symptoms of < 2 weeks' duration. All patients complained of swollen painful testicles. Other presenting symptoms included undulant fever (96%), chills (54%) and arthralgia (23%). Four patients had dysuria and one haematuria. Ten patients gave a positive history of ingestion of raw milk and milk products; one patient had laboratory-acquired brucellosis. Six patients had unilateral epididymo-orchitis (two with features of florid presentation); the remaining 20 had only orchitis (bilateral in two, right in 10 and left in eight). Leucocytosis was present in six patients; 25 had initial agglutination titres of > 1 : 320 and the remaining patient had a positive blood culture. All patients received combined therapy with streptomycin for the first 2 weeks (or oral rifampicin for 6 weeks) with doxycycline or tetracycline for 6 weeks. All showed improvement, fever subsided in 2--5 days and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year.. In brucellosis-endemic areas, clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis. A careful history, a meticulous physical examination and a rapid laboratory evaluation help in diagnosis. Clinical and serological data are sufficient for diagnosis. Leucocytosis is not an atypical feature of brucellar epididymo-orchitis and so cannot be used for differentiating it from the nonspecific variety. Conservative management with combination antibiotic therapy is adequate for managing brucellar epididymo-orchitis.

Topics: Adolescent; Adult; Aged; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Fever; Humans; Length of Stay; Male; Middle Aged; Orchitis; Retrospective Studies; Rifampin; Saudi Arabia; Streptomycin; Tetracycline

A series of 40 patients presented with epididymo-orchitis between January 1983 and August 1985. In 14 brucellosis was diagnosed. In 10 of these (72%) both testis and epididymis were involved and 1 had bilateral disease. All patients with brucella epididymo-orchitis were treated with streptomycin and tetracycline and complete resolution occurred in 8 (57%).

Topics: Adolescent; Adult; Aged; Brucellosis; Epididymitis; Humans; Male; Middle Aged; Orchitis; Streptomycin; Tetracycline

Topics: Adult; Diagnosis, Differential; Drug Combinations; Epididymitis; Gonorrhea; Hernia; Humans; Infant, Newborn; Infrared Rays; Male; Orchitis; Penicillins; Phenylbutazone; Prognosis; Prostatitis; Spermatic Cord Torsion; Sulfamethoxazole; Testicular Neoplasms; Tetracycline; Trimethoprim; Tuberculosis

Topics: Amphotericin B; Chlamydia Infections; Chloramphenicol; Condylomata Acuminata; Female; gamma-Globulins; Genital Diseases, Female; Genital Diseases, Male; Herpes Zoster; Humans; Immunoglobulins; Lymphogranuloma Venereum; Male; Molluscum Contagiosum; Mumps; Mycoplasma Infections; Orchitis; Podophyllin; Tetracycline; Vaccination; Vaccinia; Virus Diseases

Topics: Anti-Bacterial Agents; Deoxyribonuclease I; Epididymitis; Humans; Male; Mumps; Orchitis; Streptodornase and Streptokinase; Streptokinase; Tetracycline