Brucellosis of Testis and Epididymis: A Review of the Literature.

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.

Serological monitoring on brucellosis in livestock of Korea / 대한수의학회지

In Korea, brucellosis has been reported periodically in cattle and rarely in dogs; however, it has not previously been screened in domestic animals such as elk, pigs and goats. To investigate the serological prevalence, serum samples were taken from the aforementioned animals annually during 2007-2013 and screened by the rose-bengal test (RBT) or modified RBT, after which positive sera were evaluated by the standard tube agglutination test (STAT). Finally, RBT and STAT-positive sera were confirmed by competitive-ELISA. Brucella abortus biovar 1 was isolated from three elk that were shown to be positive serologically in 2008. There was no evidence of brucellosis in pigs. Based on serological monitoring and investigation of etiological agents, there is no evidence of outbreak of brucellosis in elk, pigs or goats of Korea since 2008. However, the possibility for brucellosis from cattle to affect these other livestock exists; therefore, extensive and continuous serological monitoring is required to maintain their brucellosis-free status.

Seroprevalencia de Brucella spp en estudiantes de Medicina Veterinaria, Bogotá, Colombia / Brucella spp seroprevalence in veterinary medicine students, Bogota, Colombia

Introducción: La brucelosis es un enfermedad zoonotica relacionada al contacto con perros y con ganado vacuno, porcino y caprino, el agente etiológico pertenece al género Brucella con diez especies de importancia para el ser humano; su capacidad para evadir el sistema inmune y sobrevivir en el fago-lisosoma genera un cuadro clínico crónico en el ser humano caracterizado por fiebre ondulante y afectación osteoarticular. Su amplia variedad de expresión clínica genera un reto al momento del diagnóstico y tratamiento; por tal razón es relevante el reconocimiento de las pruebas diagnósticas que permitan establecer el posible contacto con el microorganismo. Objetivo: Establecer la seroprevalencia a Brucella spp en una población de estudiantes de Medicina Veterinaria con posible exposición ocupacional. Materiales y Métodos: Estudio descriptivo observacional donde se estudiaron 272 sueros obtenidos de estudiantes de medicina veterinaria mediante la técnica de rosa de bengala. Resultados: El 18,4% (50/272) de los sujetos presento positividad por rosa de bengala; 28 hombres (56%) y 22 mujeres (44%). Conclusiones: La serología mediante rosa de bengala en esta población de riesgo evidenció un 18,5% de sujetos seropositivos. Se sugiere el empleo de barreras efectivas de protección durante el contacto con animales portadores del microorganismo durante el entrenamiento como estudiantes de Medicina veterinaria.

Introduction: Brucellosis is a zoonotic disease related to contact with dogs and cattle, pigs and goats, the etiologic agent belongs to the genus Brucella with ten species of importance to humans, its ability to evade the immune system and survive in the phage-lysosome generate a chronic clinical picture in humans characterized by undulant fever and osteoarticular involvement. Its wide range of clinical expression generates a challenge at the time of diagnosis and treatment, for this reason, it is important the recognition of the diagnostic tests for establishing the possible contact with the microorganism. Objective: To establish the seroprevalence to Brucella spp in a sample of Veterinary Medicine students with possible occupational exposure. Materials and Methods: Observational descriptive study by means of rose bengal technique 272 sera obtained from veterinary students were processed. Results: 18.4% (50/272) of subjects were positive by rose bengal test; 28 men (56%) and 22 women (44%). Conclusion: Serology by rose bengal test in this risk population showed 18.5% of seropositive subjects. It suggests the use of effective protective barriers during contact with animals carrying the organism during training as veterinary medical students.

Prevalencia de anticuerpos séricos contra la bacteria Brucella sp. en una población humana tropical

Prevalence of serum antibodies for the bacterium Brucella sp. in a tropical human population. Brucellosis is a systemic bacterial disease that can last years if not treated properly. The laboratory diagnosis is made by serological tests or isolation of the agent. We studied the prevalence of antibodies against Brucella sp. in inhabitants of rural communities of Cartago, Costa Rica, who are dedicated mainly to dairy cattle activities. We analyzed 714 representative samples with the Rose Bengal plate agglutination test (RBT) and the standard agglutination test in microplate (SAT). The overall prevalence was 0.87 %. No seroconversion was demonstrated for seropositive individuals. Even though 71 % of the population mentioned consuming non-pasteurized milk, no statistically significant association was found (1.09 %, IC 0.30-2.77) between milk consumption and the presence of antibodies suggestive of infection by Brucella sp. As a brucellosis high-risk population, the absence of symptoms in the population agrees with the observed titers of antibodies, suggesting a low previous exposure to the agent. Rev. Biol. Trop. 55 (2): 385-391. Epub 2007 June, 29.

La brucelosis es una enfermedad bacteriana generalizada con tendencia a la cronicidad si no se trata adecuadamente. El diagnóstico de laboratorio se realiza por el aislamiento e identificación del agente o en la mayoría de los casos mediante pruebas serológicas. En este estudio se informa la prevalencia de anticuerpos séricos contra Brucella sp. en habitantes de comunidades rurales de Cartago dedicadas principalmente a la ganadería de leche. Se analizó un total de 714 muestras representativas de la población mediante la técnica de aglutinación Rosa de Bengala en lámina (RBT) y la prueba de aglutinación en microplaca (SAT). Se encontró una prevalencia de 0.87 %, y en ninguna persona seropositiva se demostró seroconversión. Aún, cuando el 71 % de la población refirió consumir leche no pasteurizada, no se encontró asociación estadísticamente significativa (1.09 %, IC 0.30-2.77) entre el consumo de leche no pasteurizada y la presencia de anticuerpos sugestivos de infección por Brucella sp. A pesar de ser una zona de alta prevalencia de brucelosis bovina por Brucella abortus, la ausencia de síntomas en la población y los bajos títulos de anticuerpos observados sugieren una escasa exposición previa al agente.

Prevalence of Brucella antibodies in sera of cows in Bangladesh

The study was carried out to investigate the prevalence of Brucella antibodies in sera of 120 cows in Bangladesh Agricultural University Dairy Farm and adjacent villages, Bangladesh. The epidemiological history and blood was collected from the cows. The serum samples were subjected to Rose Bengal Test (RBT)and plate agglutination test (PAT) for initial screening of Brucella antibodies and the positive sera samples were then subjected to tube agglutination test (TAT)for further confirmation. The higher rate of Brucella antibody was recorded in rural farm (5.0%)than organized farm (2.5%)and in pregnant cows (5.9%)than non-pregnant cows (4.7%). A total of 3 (4%)Brucella positive antibody cases were recorded in cows of above four years of age whereas, 1 (2.3%)positive case was found in cows of less than 4 years of age. The study revealed that number of Red Shindi was the highest and the prevalence of brucellosis in Bangladesh cow population is not negligible and it is worthwhile to consider adoption of preventive measures.