Abstract
ABSTRACTObjectives:Brucellosis is a multi-system infectious disease that is associated with inflammation, which causes an increase in acute phase reactants. Hematological inflammatory markers of brucellosis include mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR). In this study, we aimed to evaluate the diagnostic value of hematological inflammatory markers in Brucella epididymo-orchitis (BEO), and to investigate the utility of these markers for differential diagnosis from non-Brucella epididymo-orchitis (non-BEO).Materials and Methods:We retrospectively reviewed the records of 22 BEO and 50 non-BEO patients. Hematological parameters were recorded and compared between the two groups. The main diagnostic criteria for BEO were positive clinical findings (i.e., testicular pain, tenderness and scrotal swelling), a positive Rose Bengal test result, standard tube agglutination (STA) titer ≥ 1/160, and/or a positive blood culture.Results:The most decisive factors in discriminating between BEO and non-BEO were NLR, RDW, and MPV, in decreasing order of their strength. Regardless of other factors, NLR values < 2.3 significantly increased the odds of BEO (OR=8.080, 95% CI: 1.929-33.843, p=0.004). After adjusting for other factors, RDW values >14.45% significantly increased the odds of BEO (OR=7.020, 95% CI: 1.749-28.176, p=0.006). Independent of the other factors, patients with MPV < 7.65 fL had a 6.336 times higher risk for BEO (95% CI: 1.393 - 28.822, p=0.017).Conclusion:Hematological inflammatory markers such as NLR, RDW, and MPV can aid in the differential diagnosis of BEO and non-BEO.
Highlights
Brucellosis is an endemic zoonotic disease caused by gram-negative coccobacilli that affects more than half a million patients every year [1]
neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/ lymphocyte ratio (MLR) were calculated as the ratio of neutrophils to lymphocytes, platelets to lymphocytes, and monocytes to lymphocytes, respectively
The median MLR (p=0.002) and the median mean platelet volume (MPV), median white blood cell (WBC) count, median neutrophil count, and median NLR were significantly lower in the brucella epididymo-orchitis epididymo-orchitis (BEO) group (p < 0.001), while the median red cell distribution width (RDW) and lymphocyte count were significantly higher (p < 0.001 and p=0.030, respectively)
Summary
Brucellosis is an endemic zoonotic disease caused by gram-negative coccobacilli that affects more than half a million patients every year [1]. 20-40% of cases have focal complications and single-organ involvement, which can occur in almost every organ system [3]. Focal involvement of the urogenital system is seen in 2-10% of patients. Of males affected by brucellosis, 2-20% have epididymo-orchitis, which is the most commonly involved site in the genitourinary system [4]. Brucella ibju | inflammatory markers on brucella and non-brucella epididymo-orchitis epididymo-orchitis (BEO) must be considered in the differential diagnosis of epididymo-orchitis [5]. When treated in a timely manner, BEO has a good prognosis, but any delay in its diagnosis and treatment can lead to serious complications that may require orchiectomy, such as testicular abscess [6]
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