Brucella Induced Guillain–Barré Syndrome

Elzein, Fatehi; Mursi, Mohammed

doi:10.4269/ajtmh.14-0369

Cited by 11 publications

(5 citation statements)

References 12 publications

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“…A 26-year-old woman and a 54-year-old man reported a GBS-related Brucella infection with upper and lower limb numbness, muscle weakness, and eye and facial weakness associated with GBS. Both achieved satisfactory results after appropriate immunoglobulin therapy [ 10 , 11 ]. Alanazi et al reported 19 patients with GBS during active brucellosis in 2021.…”

Section: Discussionmentioning

confidence: 99%

A case of brucellosis-induced Guillain–Barre syndrome

Liu

Jiang

et al. 2022

BMC Infect Dis

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Background Guillain–Barre syndrome (GBS) is a rare neurological complication of brucellosis, and neurobrucellosis is the most common, but they have many similarities in clinical manifestations. Many clinicians are accustomed to merely explaining the manifestations of nervous system involvement with neurobrucellosis, but they ignore the possibility of GBS, and this leads to misdiagnosis, untimely treatment, and serious consequences. Case presentation A 55-year-old male patient was admitted to The First Affiliated Hospital of Harbin Medical University for intermittent fever, fatigue, and waist pain more than three months. Brucellosis was diagnosed from the blood test. Although anti-brucella treatment was given at the time of diagnosis, the disease continued to progress. At the time of the cerebrospinal fluid systematic physical examination and the neuroelectrophysiological test, acute motor sensory axonal neuropathy was diagnosed. The patient was given immediately administered immunoglobulin therapy. After three months of systemic treatment, the patient's muscle strength of the distal limbs gradually recovered. The numbness of the limbs eased slowly, and urination function and respiratory function returned to normal. He could sit by himself. Conclusions The possibility of GBS should be closely monitored for when a brucellosis patient shows typical clinical manifestations of progressive muscle weakness, protein-cell separation of the cerebral spinal fluid, and typical demyelinating sensorimotor polyneuropathy.

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Section: Discussionmentioning

confidence: 99%

A case of brucellosis-induced Guillain–Barre syndrome

Liu

Jiang

et al. 2022

BMC Infect Dis

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“…The most reported manifestations of neurobrucellosis are meningitis and meningoencephalitis [2]. Neurobrucellosis may also present as myelitis, myelopathy, stroke, paraplegia, radiculoneuritis, intracerebral abscess, epidural abscess, intradural abscess, demyelination, Guillain-Barré syndrome, polyneuritis, and cranial nerve involvement or any combination of these manifestations [3,8,9,10]. Neurobrucellosis affects the second, third, sixth, seventh, and eighth cranial nerves.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Neurobrucellosis is a focal complication of brucellosis affecting both central and peripheral nervous system (PNS) presenting with a variety of signs and symptoms [2]. Neurologic involvement due to brucellosis was reported in 1.7%-10% of the patients with brucellosis [3,4,5]. Neurological complications of brucellosis are divided into two groups.…”

Section: Introductionmentioning

confidence: 99%

Neurobrucellosis

Abbasi¹,

Korooni²

2015

Updates on Brucellosis

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Brucellosis is a multi-system infectious disease that presents with various clinical manifestations and complications. Neurobrucellosis is an uncommon but serious presentation of brucellosis that can be seen in all stages of the disease. Neurobrucellosis is a focal complication of brucellosis affecting both central and peripheral nervous system presenting varieties of signs and symptoms. The most reported manifestations are meningitis and meningoencephalitis. It is a rare presentation of brucellosis. The estimated mean incidence of neurobrucellosis is 1.7%-10%. The incidence is equal in males and females. Initial clinical manifestations consisted of meningoencephalitis, acute and subacute meningitis, intracranial hypertension, polyradiculoneuritis, cerebral and subarachnoid hemorrhage, transverse myelitis, lumbar epidural abscess with root involvement, and cranial nerve involvement. Other rare manifestation includes pseudotumor cerebri, intracranial granuloma, sagittal sinus thrombosis, spinal arachnoiditis, and intracranial vasculitis. High index of suspicion, especially in endemic areas is essential to prevent morbidity from this disease. Clinical suspicion and accurate evaluation of a patient's history is the most important clue in diagnosis and treatment. Neurobrucellosis can be diagnosed by isolation of microorganism from the CSF or detection of antibodies in the CSF. The CSF pattern in neurobrucellosis can be helpful for diagnosis; lymphocytic pleocytosis, increased protein, and decreased glucose levels in the CSF are in favor of neurobrucellosis. Imaging modalities, including CT scan or magnetic resonance imaging, may reveal information for diagnosis. Many laboratory procedures are usually employed in the diagnosis of neurobrucellosis. Even though the culture method is the gold standard, growth rate is low and time consuming. Coombs' test should be performed in both the CSF and serum. Different regimens are usually used based on ceftriaxone, doxycycline, cotrimoxasole, streptomycin, and rifampicin. Treatment with intravenous ceftriaxone and oral rifampicin, doxycycline, and trimethoprim-sulfamethoxazole resulted in a good clinical response. Patients with severe and persistent headache and other neurologic symptoms and signs should be considered for neurobrucellosis in endemic regions. Early diagnosis and treatment of neurobrucellosis will be helpful in decreasing the sequelae of this complication.

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“…18 Further, there are reports of patients with GBS who developed the syndrome after infection with Brucella. 19 Other theories argue that the cause of GBS may be because of viral infection, 20 and some even claim that the association may not be related to infection at all. Still, most reports exhibit a negative interplay between infections and demyelination syndromes.…”

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confidence: 99%

“…In fact, severe axonal degeneration in GBS is more common following C. jejuni infection . Further, there are reports of patients with GBS who developed the syndrome after infection with Brucella . Other theories argue that the cause of GBS may be because of viral infection, and some even claim that the association may not be related to infection at all.…”

mentioning

confidence: 99%