Brucella orchitis: A case report on a rare cause of scrotal abscess leading to orchiectomy

TL;DR

A 65-year-old cattle farmer in Iran developed a rare testicular infection from Brucella, requiring surgery after antibiotics failed to fully treat it.

Contribution

This case report highlights Brucella orchitis as a rare but important cause of scrotal abscess requiring orchiectomy.

Findings

Brucellosis can lead to testicular abscesses even after systemic antibiotic treatment.

Orchiectomy was necessary due to extensive necrosis in the testicle.

Post-surgical antibiotic therapy prevented recurrence in the patient.

Abstract

Brucellosis, a zoonotic infection common in Iran, rarely causes genitourinary complications such as orchitis. We report a 65-year-old Persian cattle farmer with brucellosis who developed a testicular abscess despite antibiotic therapy. Initial treatment with rifampin and doxycycline resolved systemic symptoms, but scrotal pain prompted ultrasound, revealing a right testicular abscess. Orchiectomy was performed due to extensive necrosis, with histopathology confirming necrotizing brucellar orchitis. Post-surgical levofloxacin and clindamycin prevented recurrence at six months. This case highlights the need to consider Brucella orchitis in endemic regions when scrotal pathology persists, as advanced cases may require surgical intervention.

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