Subject(s)
Catheters, Indwelling/microbiology , Enterobacteriaceae Infections/microbiology , Kidney Failure, Chronic/therapy , Peritoneal Dialysis/adverse effects , Peritonitis/microbiology , Providencia/isolation & purification , Aged , Anti-Bacterial Agents/therapeutic use , Device Removal , Diagnosis, Differential , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/therapy , Female , Follow-Up Studies , Humans , Peritonitis/diagnosis , Peritonitis/therapyABSTRACT
Although neurological symptoms in brucellosis are frequent, central nervous system (CNS) involvement is uncommon. Five patients with neurobrucellosis are presented. Three patients presented with meningoencephalitis, one with polyradiculoneuritis and one with myelitis and an eighth nerve palsy. All patients had lymphocytic pleocytosis, low glucose and elevated levels of protein in the cerebrospinal fluid (CSF). Gamma-globulin and IgG values in the CSF were also increased. Results of agglutination tests for Brucella in serum and CSF were positive for all patients, although titres were less in the CSF. Brucella melitensis was cultured from two patients. Treatment included concurrent administration of three of the following drugs: doxycycline, rifampicin, streptomycin, co-trimoxazole, ceftriaxone or ciprofloxacin. The three patients with meningoencephalitis fully recovered; the other two patients were left with minor disability.
Subject(s)
Brucellosis/diagnosis , Central Nervous System Infections/microbiology , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Brucella melitensis , Brucellosis/drug therapy , Brucellosis/pathology , Central Nervous System Infections/diagnosis , Central Nervous System Infections/drug therapy , Central Nervous System Infections/pathology , Female , Humans , Male , Middle Aged , TurkeyABSTRACT
The hematological findings of 233 patients with brucellosis are presented and the possible pathologies discussed. Anemia was present in 128 patients (55%), leukopenia in 49 (21%) and thrombocytopenia in 59 (26%). Bone marrow aspirates of 18 patients (8%) with pancytopenia were examined. The bone marrow was hypercellular in 15 and normocellular in 3 patients. Granulomatous lesions were detected in 12 cases (67%), and slight to moderate cytophagocytosis of erythrocytes, granulocytes and platelets existed in all patients. Blood cell counts reverted to normal within 2-3 weeks of initiating chemotherapy with recovery from the disease.
