Clinical and Demographic Characteristics of Male Patients with Brucellar Epididymo-Orchitis: A Retrospective Cohort Study from an Endemic Region

Elad Mazor^1,2Rozalia Smolyakov^2,3Itai Hazan^2,4Victor Novack^2,5Igor Yusim^1,2Haim Herzberg^1,2Nicola J Mabjeesh^1,2Yarden Zohar^1,2*

• ¹Department of Urology, Soroka Medical Center, Be'er Sheva, Israel
• ²Ben-Gurion University of the Negev, Be'er Sheva, Israel
• ³Infectious Diseases Unit, Soroka Medical Center, Be'er Sheva, Israel
• ⁴IBM Research - Israel, Haifa, Israel
• ⁵Department of Internal Medicine, Soroka Medical Center, Be'er Sheva, Israel

Background: Brucellar epididymo-orchitis (BEO) is an under-recognized complication of brucellosis, which can have long-term consequences. This study aimed to identify clinical and demographic factors associated with BEO among male patients in a highly endemic population. Methods: We conducted a retrospective analysis of patients diagnosed with brucellosis confirmed by positive serological assays at our medical centre. The demographic and clinical characteristics of patients with BEO were compared with those of patients with brucellosis but without epididymo-orchitis (EO). Results: Between 2001 and 2019, 2,422 individuals presented with brucellosis. Of these, 39 (1.6%) had BEO, and 2,383 had non-EO brucellosis. Most patients in both groups were of the Bedouin ethnicity (90-94%). A comparison of age, BMI, and number of children revealed statistically significant differences. To minimize bias, a 1:3 matched comparison was performed between 117 non-EO brucellosis patients and 39 BEO patients. This comparison showed that patients with BEO had a significantly lower number of children (median of 2 vs. 6). In terms of laboratory findings, patients with BEO had a significantly higher C-reactive protein (CRP) level (median, 11 vs. 1.8). No differences were found in environmental risk factors, such as smoking. Conclusions: BEO patients were older, had higher BMI and inflammatory markers, and reported fewer children compared to non-EO brucellosis patients. These findings may reflect delayed diagnosis or chronicity, though reproductive implications remain speculative and warrant prospective evaluation.