38th Annual Meeting of the ESPID, Rotterdam, Netherlands, 26 - 29 October 2020, pp.722
Background: Brucella, a zoonosis that can cause various clinical findings with multisystemic
involvement. Also known as Mediterranean fever, this disease most commonly involves the bone-joint
system, as well as causing cardiovascular, pulmonary, neurological, intraabdominal and genitourinary
complications. It is known that it causes an epididymo-orchitis in a rate of 2-20% in adult age group. Here,
an adolescent case with scrotal involvement is presented.
Case Presentation Summary: A 17 years old male patient applied to a health center with weakness for
two months, weight loss and ongoing fever that started a week ago.In the scrotal imaging performed with
suspicion of malignancy, millimeter multifocal hypoechoic nodular infiltrations were detected. The patient
was guided by the diagnosis of lymphoma due to the thoracic and abdominal imaging.
Hepatosplenomegaly and pancytopenia detected on physical examination and complet blood count,
respectively. Serum samples were also sent for Brucella along with viral serologies from the patient who
lives in the Eastern Anatolia Region, in Turkey and is ranching. Also, Brucella culture was sent from bone
marrow aspiration sample for malignancy exclusion.While other viral serologies of the patient were
negative, both Rose-Bengal test, Wright’s test and Brucella culture were positive.After the appropriate
antimicrobial treatment started, full response was obtained clinically, laboratory and radiologically.
Learning Points/Discussion: Although the place of brucellosis in epididymo-orchitis is more common in
adults, it is very rare in the child age group even endemic regions like our country. It is possible to treat
this disease, which can result in severe morbidity and mortality due to multiple organ involvement. It
should definitely come to mind in the presence of fever, pancytopenia and organomegaly with scrotal