SHM Converge Scientific Abstract ePoster Gallery-A Case of Genitourinary Brucellosis

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This case describes a 33-year-old man with gout who presented with 5 days of intermittent fever, right testicular pain, and swelling. He denied urinary symptoms, genital discharge, rash, or prior sexually transmitted infections. Exam showed a tender, swollen right testicle, and labs were largely unremarkable aside from fever and tachycardia. Urinalysis and STI testing were negative.<br /><br />Scrotal ultrasound demonstrated epididymo-orchitis with a 1.1 cm right testicular abscess. He was initially treated empirically with antibiotics and discharged with urology follow-up, but blood cultures later grew gram-negative coccobacilli. After recall to the ED, repeat ultrasound showed enlargement of the abscess to 1.5 cm. Blood cultures were ultimately identified as Brucella melitensis, and he was diagnosed with genitourinary brucellosis.<br /><br />His social history included living on a ranch in Mexico years earlier and working as a cargo handler at an international airport, suggesting possible exposure risk. He denied unpasteurized dairy intake. He was transitioned to doxycycline and rifampin for 6 weeks through infectious disease follow-up. After completing therapy, his symptoms resolved and follow-up ultrasound confirmed resolution of the testicular abscess.<br /><br />The case highlights that brucellosis should be considered in patients with acute scrotal pain, epididymo-orchitis, or testicular abscess, especially when blood cultures show gram-negative coccobacilli and routine STI/urinary studies are negative. Genitourinary brucellosis, though uncommon, can occur in young men and may require prolonged antibiotics to prevent recurrence and complications such as infertility or testicular necrosis.

Asset Subtitle

Lauren Y. Nguyen

Meta Tag

Author List Dana Russell, Evan J. Chen, Kusha Davar, Lauren Y. Nguyen

Category Clinical Vignettes

Concept Genitourinary Brucellosis

Concept Brucellosis

Concept Epididymo-orchitis

Concept Testicular Abscess

Concept Brucella Species

Distinguished Non-Finalist

Presenter Organization University of Southern California/Los Angeles General Medical Center

Presenting Author Lauren Y. Nguyen

Track Adult

Keywords

brucellosis

genitourinary brucellosis

epididymo-orchitis

testicular abscess

Brucella melitensis

scrotal pain

gram-negative coccobacilli

doxycycline

rifampin

infertility risk

Genitourinary Brucellosis

Brucellosis

Epididymo-orchitis

Testicular Abscess

Brucella Species