Assessment of Hematological Parameters in the Diagnosis Brucella Epididymorchitis: Comparison of Brucella Epididymorchitis and Non-Brucella Epididymorchitis

Abstract

Objective: To analyze the parameters that can facilitate the differential diagnosis of brucella epididymorchitis (BEO) and non-brucella epididymorchitis (NBEO) and to facilitate early diagnosis. Material And Methods: The data of 23 BEO patients and 80 NBEO patients, who applied in a tertiary center in eastern Turkey, where brucellosis is common, were retrospectively analyzed. Age, hemogram parameters (white blood cell (WBC)), neutrophil, lymphocyte, monocyte, eosinophil, basophil, platelet, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), red blood cell distribution width (RDW), biochemical parameters (aspartate transaminase and alanine aminotransferase), inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, and procalcitonin), urine culture, and scrotal doppler ultrasound findings were analyzed retrospectively and were compared between BEO and NBEO groups. Results: In the comparison of the BEO and NBEO groups, there was a significant difference between the two groups in WBC count, neutrophil count, monocytes count, NLR, MLR, MPV, and procalcitonin levels (p = 0.035, p = 0.007, p = 0.003, p = 0.005, p = 0.01, p < 0.001, p < 0.001, respectively). Conclusions: The NLR may be promising for use in the early diagnosis of BEO. The MPV also drew attention as parameters that can be evaluated

Keywords

• brucellosis
• genitourinary
• infections
• epididymorchitis

Brucella Epididimorşiti Tanısında Hematolojik Parametrelerin Değerlendirilmesi: Brucella Epididimorşiti İle Non-Brucella Epididimorşitlerin Karşılaştırılması

Abstract

Amaç: Brucella epididimorşit (BEO) ile brusella dışı epididimorşitin (NBEO) ayırıcı tanısını kolaylaştırabilecek ve erken tanıyı kolaylaştırabilecek parametreleri araştırmak. Gereç ve Yöntemler: Brusellozun yaygın olduğu Türkiye’nin doğusunda üçüncü basamak bir merkeze başvuran 23 BEO hastası ve 80 NBEO hastasının verileri retrospektif olarak incelendi. Yaş, hemogram parametreleri (beyaz kan hücresi (WBC), nötrofil, lenfosit, monosit, eozinofil, bazofil, trombosit, nötrofil-lenfosit oranı (NLR), monosit-lenfosit oranı (MLR), trombosit-lenfosit oranı (PLR), ortalama trombosit hacmi (MPV), kırmızı kan hücresi dağılım genişliği (RDW)), biyokimyasal parametreler (aspartat transaminaz ve alanin aminotransferaz), inflamatuar belirteçler (C-reaktif protein, eritrosit sedimantasyon hızı ve prokalsitonin), idrar kültürü ve skrotal doppler ultrason bulguları retrospektif olarak incelendi. BEO ve NBEO gruplarının sonuçları karşılaştırıldı. Bulgular: BEO ve NBEO gruplarının karşılaştırılmasında, iki grup arasında WBC sayısı, nötrofil sayısı, monosit sayısı, NLR, MLR, MPV ve prokalsitonin seviyeleri açısından anlamlı fark vardı (sırasıyla p = 0,035, p = 0,007, p = 0,003, p = 0,005, p = 0,01, p < 0,001, p < 0,001). Sonuçlar: NLR, BEO’nun erken tanısında kullanım için umut verici olabilir. MPV de değerlendirilebilecek bir diğer parameter olarak dikkat çekmektedir.

Keywords

• brusellozis
• genitoüriner
• enfeksiyon
• epididimorşit

References

1. 1. Savasci U, Zor M, Karakas A, Aydin E, Kocaaslan R, Oren NC, et al. Brucellar epididymo-orchitis: a retrospective multicenter study of 28 cases and review of the literature. Travel medicine and infectious disease. 2014;12(6):667-72. https://doi.org/10.1016/j.tmaid.2014.10.005
2. 2. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. The Lancet infectious diseases. 2006;6(2):91-9. doi.org/10.1016/S1473-3099(06)70382-6
3. 3. Colmenero JD, Munoz-Roca NL, Bermudez P, Plata A, Villalobos A, Reguera JM. Clinical findings, diagnostic approach, and outcome of Brucella melitensis epididymo-orchitis. Diagnostic microbiology and infectious disease. 2007;57(4):367-72. https://doi.org/10.1016/j.diagmicrobio.2006.09.008
4. 4. Gul HC, Akyol I, Sen B, Adayener C, Haholu A. Epididymoorchitis due to Brucella melitensis: review of 19 patients. Urologia Internationalis. 2009;82(2):158-61. https://doi.org/10.1159/000200791
5. 5. Navarro-Martinez A, Solera J, Corredoira J, Beato JL, Alfaro EM, Atiénzar M, et al. Epididymoorchitis due to Brucella mellitensis: a retrospective study of 59 patients. Clinical infectious diseases. 2001;33(12):2017-22. https://doi.org/10.1086/324489
6. 6. Akıncı E, Bodur H, Çevik MA, Erbay A, Eren SS, Zıraman İ, et al. A complication of brucellosis: epididymoorchitis. International journal of infectious diseases. 2006;10(2):171-7. https://doi.org/10.1016/j.ijid.2005.02.006
7. 7. Banyra O, Shulyak A. Acute epididymo-orchitis: staging and treatment. Central European journal of urology. 2012;65(3):139. doi.org/10.5173%2Fceju.2012.03.art8
8. 8. Aydemir H, Budak G, Budak S, Celik O, Yalbuzdag O, Keles I. Different presentation types of primary Brucella epididimo-orchitis. Archivio Italiano di Urologia e Andrologia. 2015;87(2):151-3. https://doi.org/10.4081/aiua.2015.2.151

9. 9. Aktar F, Tekin R, Bektaş MS, Güneş A, Köşker M, Ertuğrul S, et al. Diagnostic role of inflammatory markers in pediatric Brucella arthritis. Italian Journal of Pediatrics. 2016;42(1):1-6. https://doi.org/10.1186/s13052-016-0211-5
10. 10. Paixão TA, Roux CM, Hartigh ABd, Sankaran-Walters S, Dandekar S, Santos RL, et al. Establishment of Systemic Brucella melitensis Infection through the Digestive Tract Requires Urease, the Type IV Secretion System, and Lipopolysaccharide O Antigen. Infection and Immunity. 2009;77(10):4197-208. https://doi.org/10.1128/IAI.00417-09
11. 11. Solera J. Update on brucellosis: therapeutic challenges. International journal of antimicrobial agents. 2010;36:S18-S20. https://doi.org/10.1016/j.ijantimicag.2010.06.015
12. 12. Cift A, Yucel MO. Comparison of inflammatory markers between Brucella and non-Brucella epididymo-orchitis. International braz j urol. 2018;44:771-8. https://doi.org/10.1590/S1677-5538.IBJU.2018.0004.0
13. 13. Korkmaz N, Ölçücü MT, Ateş F. Comparision of Brucella and Non-Brucella Epididymo-orchitis. Age (year). 2020;26(8.15):48.53-21.78. https://doi.org/10.29271/jcpsp.2020.04.403
14. 14. Aydin E, Karadag MA, Cecen K, Cigsar G, Aydin S, Demir A, et al. Association of mean platelet volume and the monocyte/lymphocyte ratio with Brucella-caused epididymo-orchitis. Southeast Asian J Trop Med Public Health. 2016;47(3):450-6.
15. 15. Papatsoris AG, Mpadra FA, Karamouzis MV, Frangides CY. Endemic Brucellar epididymo-orchitis: a 10-year experience. International journal of infectious diseases. 2002;6(4):309-13. https://doi.org/10.1016/S1201-9712(02)90166-9
16. 16. Kolaczkowska E, Kubes P. Neutrophil recruitment and function in health and inflammation. Nat Rev Immunol. 2013;13(3):159-75. https://doi.org/10.1038/nri3399
17. 17. Liew PX, Kubes P. The Neutrophil’s Role During Health and Disease. Physiol Rev. 2019;99(2):1223-48. https://doi.org/10.1152/physrev.00012.2018
18. 18. Balın ŞÖ, Tartar AS, Akbulut A. The predictive role of haematological parameters in the diagnosis of osteoarticular brucellosis. African health sciences. 2018;18(4):988-94. https://doi.org/10.4314/ahs.v18i4.19
19. 19. Öztürk ZA, Sayıner H, Kuyumcu ME, Yesil Y, Savas E, Sayıner ZA, et al. Mean platelet volume in assessment of brucellosis disease. Biomed Res-India. 2012;23(4):541-6.
20. 20. Okan DH, Gökmen Z, Seyit B, Yuksel K, Cevdet Z, Deniz A. Mean platelet volume in brucellosis: correlation between Brucella standard serum agglutination test results, platelet count, and C-reactive protein. African Health Sciences. 2014;14(4):797-801. https://doi.org/10.4314/ahs.v14i4.4
21. 21. Togan T, Narci H, Turan H, Ciftci O, Kursun E, Arslan H. The impact of acute brucellosis on mean platelet volume and red blood cell distribution. Jundishapur Journal of Microbiology. 2015;8(2). https://doi.org/10.5812%2Fjjm.20039