ABSTRACT
Although neurological symptoms in brucellosis are frequent, central nervous system [CNS] involvement is uncommon. A 42-year-old man was admitted with an episode of faint without loss of consciousness, right hemi paresis, diplopia and headache lasting for four days. The neurological examination revealed left hemi paresis. Limitation of gazing in left eye in lateral view was seen [partial paresis of 6[th] cranial nerve]. The results of laboratory examinations show positive Wright and Coombs Wright in blood and C.S.F. In the brain CT scan hydrocephaly and in magnetic resonance imaging [MRI] some brain atrophy, few high signal foci in the deep with mater had been detected. Treatment included concurrent administration of three drugs: doxycycline, rifampicin and co-trimoxazole. This patient fully recovered. We suggest that Neurobrucellosis [NB] should always be sought in young patients with ischemic stroke, especially if they do not have any additional risk factors for stroke and live in an endemic area for brucellosis, even if they do not have other systemic signs of brucellosis
Subject(s)
Humans , Male , Brucellosis/blood , Brucellosis/cerebrospinal fluid , Brucellosis/diagnosis , Brucellosis/drug therapy , Brucellosis/diagnostic imaging , Diplopia/etiology , Diplopia/drug therapy , Headache/etiology , Headache/drug therapy , Neurologic Manifestations/etiology , Neurologic Manifestations/drug therapy , Paresis/etiology , Paresis/drug therapy , Doxycycline , Rifampin , Trimethoprim, Sulfamethoxazole Drug CombinationABSTRACT
Brucellosis is a common zoonotic infection that is endemic in many parts of the world. Neurological involvement is a rare entity, occurs in 2-5% of cases. Neurobrucellosis comprises a variety of complications, including meningitis, meningoencephalitis, myelitis and myelopaties, peripheral and cranial neuropathies, and psychiatric manifestations. The aim of the present study was to evaluate neurological manifestations and cerebrospinal fluid [CSF] findings in a group of Iranian patients with neurobrucellosis. During a 10-year period [1996-2005], medical records of 43 hospitalized patients with definite diagnosis of neurobrucellosis were studied. Inclusion criteria were a minimum titer of 1/160 for Wright and abnormal CSF findings. Age, gender, neurological manifestations, CSF analysis and its changes were investigated. Neurological manifestations include meningitis [64.9%], meningoencephalitis [11.6%], cranial nerve palsy [11.6%], brain abscess [2.4%], myelitis [2.4%] and psychiatric disorders [6.9%]. Pleocytosis [100%], high protein [40%] and low glucose levels [40%] were noted in CSF analysis clinical manifestations and CSF abnormality of nearobrucellosis is similar to tuberculosis an nearobrucellosis must be kept in mind in approach of patients with acute or chronic lymphocytic meningitis with increased protein and low glucose level in CSF and risk factors of brucellosis
Subject(s)
Humans , Male , Female , Brucellosis/cerebrospinal fluid , Neurologic Manifestations , Diagnosis, Differential , Retrospective Studies , Meningitis/cerebrospinal fluid , Meningitis/microbiology , Enzyme-Linked Immunosorbent Assay , Glucose/cerebrospinal fluid , TuberculosisABSTRACT
É relatado o caso de paciente com menigite brucelótica genuína, enfatizando-se fatores endêmicos e epidemiológicos em nosso país, bem como controvérsias sobre os testes imunológicos na vigência do quadro na fase aguda e em grupos etários de baixa idade