ABSTRACT
Background: Brucellosis is a zoonotic disease which can afflict a number of organs and tissues. Brucellosis epididymo-orchitis (BEO), a complication of human brucellosis, can lead to other complications. In brucellosis non-endemic areas, some clinicians may be unfamiliar regarding the disease entity which may lead to delay in the diagnosis. Aims: To review the literature on BEO, in order to document its presentation, diagnosis, management and outcome following treatment. Methods: Various internet data bases were used to obtain literature on BEO. Results/Literature Review: BEO (epididymitis plus or minus orchitis) is a complication of brucella species which can be transmitted by direct contact through the respiratory tract, skin, or conjunctiva, and through the gastrointestinal tract after ingestion of unpasteurized milk/milk products or raw infected meat. BEO may in endemic areas affect 2 to 20% of patients with brucellosis but the disease can also be encountered sporadically globally in non-endemic areas. BEO may at times be bilateral. The presentation of BEO is non-specific and it may be mistaken for non-specific epididymo-orchitis or epididymitis or testicular tumour or abscess. Ultrasound and MRI scan findings are not specific to BEO. Diagnosis of BEO may be established by (a) history of contact, (b) cultures from blood/epididymal aspirations, (c) various types of laboratory studies including (I) Culture, (II) Polymerase chain reaction (PCR), and (III) serology. Laboratory criteria for the diagnosis of Brucellosis is divided into (I) those for presumptive diagnosis and (II) those for confirmatory diagnosis: BEO can be effectively treated by means of combination chemotherapy for about six weeks but at times ochidectomy or drainage of testicular collection may be required for persistence of symptoms or suspicion of a tumour/testicular abscess. Relapses can occur therefore careful follow-up is required. Conclusions: BEO can occur anywhere globally. A high index of suspicion is required from clinicians in order to establish early diagnosis. Most cases of BEO can be effectively treated with combination chemotherapy for about 6 weeks and triple antibiotic therapy would appear to be most effective and associated with absence or reduction of relapse.
ABSTRACT
Background: Men are known to have prostate glands but not women. The thought of prostate gland occurring in the female genital tract in women would be petrifying to all clinicians and people who are not aware of its biological behavior. Ectopic prostate in the uterine cervix (EPIUC) and the female genital tract (FGT) is very rare. Aim: To review the literature on EPIUC/FGT and to document its biological behavior. Methods: Information obtained from 17 references, was used for the literature review on EPIUC/FGT. Results: Few cases of EPIUC/FGT have been reported at ages ranging between 21 and 82 years EPIUCs/FGTs may be diagnosed incidentally in biopsies of the cervix/vagina/vulva, or in hysterectomy specimens or they may mimic leiomyomas. Histological examination of cervical biopsies or of the cervix in hysterectomy specimens reveals ducts and acini some papillary or cribriform, with prominent squamous metaplasia EPIUCs/FGTs show positive Immunohisto-chemical staining for prostate specific antigen (PSA), prostatic-specific acid phosphatase (PSAP [PAP]), high molecular weight keratin (for basal cells). EPIUCs reported so far have exhibited benign behavior. Conclusions: Information obtained from the literature would indicate that EPIUCs / FGTs are rare and so far have exhibited benign behavior. Clinicians should report cases of EPIUC/FGT in order to establish whether or not EPIUCs/FGTs may or may not develop into carcinomas in the future.