Can Indirect Inflammatory Markers Differentiate Brucella Epididymo-Orchitis From Non-Brucella Epididymo-Orchitis? /

Abstract

Objective: This study aimed to evaluate the value of direct and indirect markers showing inflammation in the diagnosis of Brucella epididymo-orchitis (BEO) and its differentiation from non-Brucella epididymo-orchitis. Material and Methods: A total of 152 patients that presented to our clinic with acute scrotal complaints and were diagnosed with epididymo-orchitis between January 2015 and January 2019 were retrospectively evaluated. Excluded from the study were 15 patients with a hematologic disease, coronary artery disease or malignant diagnosis, eight patients aged below 18 years, and 13 patients whose hemogram and C-reactive protein (CRP) values were not available in their medical records. The diagnosis of epididymo-orchitis was based on laboratory (leukocytosis, CRP elevation) and radiological findings. The diagnosis of BEO was defined as ≥1/160 titer value and/or positive blood culture in the standard tube agglutination (STA) test in addition to orchitis symptoms and signs. Results: The median WBC (p=0.033), neutrophil (p=0.013) and monocyte (p=0.006) counts and NL (p=0.014) and ML (p=0.002) ratios were statistically significantly lower in the BEO group. The ML ratio had the highest predictive value with an AUC of 0.725 (95% CI = 0.146-0.424; p=0.002), as well as high specificity (97.3%) and diagnostic accuracy (83.5%) in predicting a BEO diagnosis. No parameter was an independent factor in the differentiation of BEO and NBEO. Conclusions: Easy, fast and low-cost hemotological inflammatory markers provide diagnostic benefits complementing serological tests in distinguishing BEO from NBEO cases. In particular, MLR has a high diagnostic accuracy compared to other parameters

Keywords

• brucella
• epididymo-orchitis
• infectious diseases
• monocyte/lymphocyte ratio