Clinical Characterization of Neurobrucellosis in Kashi Region / 中山大学学报(医学科学版)

ABSTRACT

ObjectiveTo explore the clinical characteristics of neurobrucellosis in Kashi， Xinjiang Uygur Autonomous Region， thus improve the diagnosis and treatment. MethodsA retrospective analysis was conducted on the clinical data of 18 cases of neurobrucellosis who were admitted to the First People's Hospital of Kashi Prefecture between December 2019 and January 2024. ResultsThe study included 9 males and 9 females， with a median age of 36 years （range： 17-54.5）. A clear epidemiological history was found in all the 18 brucllosis patients， 12 of whom presented with meningoencephalitis， 5 meningitis， and 1 encephalitis. Two comorbided with spinal meningitis， 2 osteoarthritis and 1 epididymitis. Most frequently reported clinical symptoms were headache， fever and fatigue. The prevalence rates of brucellosis by rose bengal plate agglutination test （RBPT） and serum agglutination test （SAT） were 11/12 and 8/9， respectively. Two of 10 patients had positive blood cultures， four of 16 had positive cerebrospinal fluid （CSF） cultures and five of five were detected to be positive by next-generation sequencing （NGS） for pathogens in CSF. CSF showed exudative changes and elevated number of leukocytes， with predominance of single nucleated cells. All patients were treated with the combined use of two to four from the drugs like doxycycline， rifampicin， ceftriaxone， cefixime， minocycline， levofloxacin and sulfanilamide. Most patients had a favorable prognosis. ConclusionsNeurobrucellosis should be considered in all patients with central nervous system manifestations from endemic areas. If there are exudative changes in CSF， differential diagnoses can be made by serological testing， blood culture， CSF culture and NGS. NGS could significantly increase the accuracy for neurobrucellosis diagnosis.