Imaging Findings of Testicular Abscess and Sacroiliitis as a Rare Complication of Brucellosis

Brucella is a global cause of zoonotic infection and is mostly transmitted to humans through unpasteurized milk and dairy products. Brucella can affect many organs focally or systemically and cause different symptoms. However, brucella has a specific affinity for the musculoskeletal system. The most common symptoms in brucella patients are related to musculoskeletal involvement. Musculoskeletal involvements are generally in the form of spondylodiscitis (usually in the lumbar region), sacroiliitis, bursitis, and osteomyelitis. Brucella most commonly causes unilateral epididymoorchitis in the genitourinary system. In brucella epididymoorchi- tis, if the diagnosis is delayed or wrong treatment options are applied, serious complications such as necrotizing orchitis and testicu- lar abscess may result, and orchiectomy may be required. Ultrasound plays an important role in diagnosis and patient follow-up in brucella epididymoorchitis. MRI, on the other hand, is an effective imaging method in revealing the relationship of the lesion with the testis and the correct localization, thanks to its higher contrast resolution and multi-plane techniques. In countries where brucella is endemic, brucella infection should be considered in cases of epididymoorchitis that does not respond to treatment or in cases of accompanying sacroiliitis and spondylodiscitis.