Direk Ve İndirek İnflamatuar Belirteçler Brusella Epididimo-Orşiti Non-Brusella Epididimo-Orşitten Ayırabilir Mi?

Giriş: Çalışmamızda inflamasyonu gösteren direk ve indirek belirteçlerin Brusella epididimo-orşit (BEO) tanısında ve Brusella dışı epididimo-orşit (NBEO) ayırıcı tanısındaki değerinin araştırılması amaçlanmıştır.Materyal Metod: Ocak 2015 ve Ocak 2019 yılları arasında akut skrotum kliniği ile başvuran epididim orşit tanısı alan 152 hasta retrospektif olarak değerlendirildi. Hematolojik hastalığı, kroner arter hastalığı, malignite tanısı olan 15 hasta, 18 yaşından küçük 8 hasta ve hemogram ve CRP sonuçlarına ulaşılamayan 13 hasta çalışma dışı bırakıldı. Epidimo-orşit tanısı fizik muayene bulguları yanında laboratuvar (lökositoz, CRP yüksekliği) ve radyolojik bulgular baz alınarak koyuldu. BEO tanısı orşit semptom ve bulgularına ek olarak pozitif kan kültürü ve standart tüp aglütinasyon (STA) testinde ≥1/160 titre değeri olarak tanımlandı.Bulgular: Ortalama WBC (p=0.033), nötrofil (p=0.013), monosit sayısı (p=0.006), nötrofil lenfosit (NL) (p=0.014) oranı ve monosit lenfosit (ML) (p=0.002) oranı BEO grubunda istatistiksel olarak anlamlı şekilde daha düşük izlendi. BEO tanısını öngörmede ML oranı yüksek prediktif değere (AUC değeri: 0.725, 0.146-0.424; p=0.002), yüksek özgüllük (97.3%) ve tanı doğruluk oranına (83.5%) sahipti. Hiçbir parametre BEO ve NBEO tanısını öngörmede bağımsız bir belirteç değildi.Sonuç: Kolay, hızlı ve düşük maliyetli hemotolojik inflamatuar belirteçler, BEO tanılı olguları NBEO tanılı olgulardan ayırmada etkili olduğu bulunmuştur. Özellikle ML oranı diğer parametrelere nazaran yüksek tanı doğruluk oranına sahiptir..

Anahtar Kelimeler:

Brusella, Epididimo-orşit, Enfeksiyöz hastalıklar, Monosit/Lenfosit oranı

Can Indirect Inflammatory Markers Differentiate Brucella Epididymo-Orchitis From Non-Brucella Epididymo-Orchitis?

Introduction: This study aimed to evaluate the value of direct and indirect markers showing inflammation in the diagnosis of Brucella epididymo-orchitis (BEO) and its differentiation from non-Brucella epididymo-orchitis.Materials and Methods: A total of 152 patients that presented to our clinic with acute scrotal complaints and were diagnosed with epididymo-orchitis between January 2015 and January 2019 were retrospectively evaluated. Excluded from the study were 15 patients with a hematologic disease, coronary artery disease or malignant diagnosis, eight patients aged below 18 years, and 13 patients whose hemogram and C-reactive protein (CRP) values were not available in their medical records. The diagnosis of epididymo-orchitis was based on laboratory (leukocytosis, CRP elevation) and radiological findings. The diagnosis of BEO was defined as ≥1/160 titer value and/or positive blood culture in the standard tube agglutination (STA) test in addition to orchitis symptoms and signs.Results: The median WBC (p=0.033), neutrophil (p=0.013) and monocyte (p=0.006) counts and NL (p=0.014) and ML (p=0.002) ratios were statistically significantly lower in the BEO group. The ML ratio had the highest predictive value with an AUC of 0.725 (95% CI = 0.146-0.424; p=0.002), as well as high specificity (97.3%) and diagnostic accuracy (83.5%) in predicting a BEO diagnosis. No parameter was an independent factor in the differentiation of BEO and NBEO.Conclusions: Easy, fast and low-cost hemotological inflammatory markers provide diagnostic benefits complementing serological tests in distinguishing BEO from NBEO cases. In particular, the ML ratio has a high diagnostic accuracy rate compared to other parameters.

Keywords:

Brucella, epididymo-orchitis, infectious diseases, monocyte/lymphocyte ratio,

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