Neurobrucellosis in a patient with multiple
Fifteen patients had headache since onset of illness. Nervous system brucellosis: diagnosis and treatment.
Neurobrucellosis NB can occur with acute or chronic meningitis, meningoencephalitis, myelitis, radiculitis, cranial nerve involvement, spinal or brain abscess, subarachnoid hemorrhage, ischemic or hemorrhagic stroke, and neuropsychiatric symptoms. The treatment of neurobrucellosis is still controversial. Abstract This case describes a patient presenting with acute onset papilledema, subacute strokes resulting in upper extremity weakness and numbness, arthritis, maculopapular rash, depressed C4 and CH50, and a high titer anti-double-stranded DNA antibody. At presentation, the patient had newly developed loss of muscle strength in the left arm and leg. Brucella bacteria may affect the nervous system directly or indirectly, as a result of cytokine or endotoxin on the neural tissue. Trimetoprim-Sulfamethoxazole in brucellosis. These symptoms were considered as a central nervous system infection and they were admitted to the infectious disease clinic. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations. CNS involvement is generally in meningoencephalitis form. Young J E. Ann Clin Microb Antimicrob. All patients had the diagnosis established by STA test. Eleven patients cases had presented symptoms and signs such as fever, neck stiffness, cranial nerve palsies. Brucella was never isolated from the CSF.
The most common symptoms of human brucellosis infection include fever, headache, arthralgia, malaise, and sweating [ 21314 ]. They were admitted to the neurology clinic. The first group had meningovascular complications as prominent signs.
Except one case 13all patients had a history of using unpasteurized dairy products. Brucellosis is still a major public health problem in developing countries such as our country. Headache and psychiatric symptoms may develop due to the toxic effect of neurobrucellosis, but intracranial hypertension is a result of meningoencephalitis.
Additionally, hematologic system, central nervous system, cardiopulmonary system and genitourinary system can be involved to some extent. Five patients had small vessel vasculitis, three had great vessel vasculitis, and one had meningoencephalitis and pons abscess. The patients' symptoms, physical examination, laboratory and radiographic findings, treatments, and treatment responses are discussed. Brain ; As noted in previous reports, the sign and symptoms of meningeal involvement are non-specific in neurobrucellosis. We report a case of neurobrucellosis mimicking the symptoms, laboratory data, and the pathologic findings that can be seen in systemic lupus erythematosus SLE , thus demonstrating the diagnostic challenges of such a heterogeneous disease. METHOD Nine patients who were admitted to our Neurology Clinic between and for various reasons in whom brucellosis was found in etiology were retrospectively studied. Am J Neuro Radiol. However, the parotid gland swelling emerged during the meningitis and improved with continued brucellosis therapy. For the four patients cases 5, 7, 11, 12 who had cranial nerve involvement and toxicity, prednisolone was used. At presentation, the patient had newly developed loss of muscle strength in the left arm and leg. Case 12 had complaints of weakness, speech disturbance, double vision and imbalance for two weeks. In our series the maleto-female ratio was 1.
based on 87 review