We describe the case of a 37-year-old man with a previous active life who complained of osteoarticular pain of variable location in the last month and fever in the last week with peaks (morning and evening) of 40 C.
Before the onset of symptoms she was in Extremadura in an endemic region of brucella, taking pasteurized milk and cheese from that cattle.
Among the diners appeared several cases of brucellosis.
During admission for study of the febrile syndrome with epidemiological history of possible exposure to Brucella presents a picture of right orchiepididymitis.
Physical examination revealed: Ta 40.2 C; T.A: 109/68 mmHg; Fc: 105 bpm.
She is conscious, oriented, sweating, eupneic, with good nutritional status and hydration.
Adenopathy, goiter or jugular vein engorgement, with symmetrical carotid pulses, is not present in the head and neck.
Auscultation cardiac arrhythmia, not murmurs, ropes or extracts.
Pulmonary emphysema with vesicular murmur conservation.
Abdomen blade, depressible, without masses or enlargement.
Neurological examination revealed no meningeal signs or focality data.
Extremities without varices or edemas.
Peripheral peace present and symmetrical.
Urological examination revealed an enlarged right test, not attached to the skin, with fluctuating areas and intensely painful positive test results, with loss of the epididymis-icular limit.
Analytical data show the following results: Hemogram: Hb 13.7 g/dl; leukocytes 14.610/mm3 (neutrophils 77%); platelets 3000/mm3.
VSG: 40 mm 1 hour.
Coagulation: TQ 87%; TTPA 25.8 sec. Biochemistry: Glucose 117 mg/dl; urea 29 mg/dl; creatinine 0.9 mg/dl; sodium 136 mEq/l; alkaline calcium 11 mEq/l
During admission, blood cultures were requested: positive for Brucella and specific serologies for Brucella: Rose Bengala +++; Coombs test > 1/1280; Brucellacapt.
The imaging tests requested (chest X-ray, abdominal ultrasound, cranial CAT, transthoracic echocardiography) do not show significant pathology, except for testicular ultrasound, which shows a small amount of hypoechoic test septa with increased pocket.
With the diagnosis of orchiepididymitis secondary to Brucella symptomatic treatment (antipyretics, restomycin and testicular elevation) as well as specific antibiotic treatment: 6 weeks 1 gram (oral strenuous)
The patient improved significantly after one week of admission and discharged home where he completed antibiotic treatment.
In successive reviews in consultations, complete remission of the condition was observed.
