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ORIGINAL ARTICLE
Year : 2020  |  Volume : 15  |  Issue : 2  |  Page : 157-160

Rickettsial epididymo-orchitis – An emerging threat in endemic areas


1 Department of Urology, Shri BM Patil Medical College and Hospital Research Centre, Bijapur, Karnataka, India
2 Department of Surgery, Division of Urology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India

Correspondence Address:
Dr. Nilesh Guru
Assistant Professor, Depratment of Surgery, Urology Division Sawangi (Meghe) Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_113_20

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Introduction: Rickettsial infections are reemerging infections in various parts of the world. Although there can be protean manifestations of rickettsial infection, epididymo-orchitis is by far uncommon. Materials and Methods: Fifty patients with a mean age of 35.1 (17–67) years with signs and symptoms suggestive of acute epididymo-orchitis were evaluated and 15 of these positive for Weil–Felix Reaction were included in the study after ruling out the common causes of epididymo-orchitis. Results: Fifteen patients had positive Weil–Felix reaction and were considered to have rickettsial epididymo-orchitis. Seven patients had right, 5 had left, while 3 had bilateral epididymo-orchitis. Most of the patients presented within 2 weeks of onset of symptoms. Five patients were positive for OX2, four patients were positive for OXK titers, four for OX19 and OX2, while two were positive for OX19 Weil–Felix reaction. These patients were started on doxycycline 100 mg bd for 7 days and followed up. In the follow-up, none of them developed complications of testicular abscess or chronic epididymo-orchitis. Conclusion: Rickettsial epididymo-orchitis is a very rare entity and it as an emerging threat in endemic areas. We strongly recommend that in the areas endemic for Rickettsia, all cases of epidiymo-orchitis should be evaluated for the presence of rickettsial infection, as early identification of such an infection would lead to prompt and precise management.


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