Management of Neurobrucellosis: An Assessment of 11 Cases

Gül, Hanefi Cem; Erdem, Hakan; Görenek, Levent; Ozdag, Mehmet Fatih; Kalpakci, Yasin; Avcı, İsmail Yaşar; Beşirbellioğlu, Bülent; Eyigün, Can Polat

doi:10.2169/internalmedicine.47.0866

Cited by 44 publications

(30 citation statements)

References 21 publications

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“…Özellikle hastalığın başlangıç aşamasında serolojik testlerin negatif olduğu dönemde pozitif sonuç verebilir [23]. Radyoloji: Nörobrusellozda radyolojik olarak görülebilecek değişiklikler; inflamatuvar lezyonlar, beyaz cevherde sinyal değişiklikleri, hidrosefali/beyin ödemi veya iskemik vasküler lezyonlardır [24,25]. Erdem ve ark.…”

Section: Tanıunclassified

Neurobrucellosis

Tanyel

2017

Ortadogu Tıp Derg

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ÖzBrusellosis ülkemizde endemik olarak görülen bir zoonotik hastalıktır ve sıklıkla pastörize olmamış süt ve süt ürün-lerinin tüketilmesi ile bulaşır. Nörobrusellozis hastalığın ciddi bir komplikasyonudur ve hastalığın herhangi bir safhasında gelişebilir. Nörobrusellozda klinik spektrum santral ve periferal olarak sınıflandırılır. En sık görülen klinik tablolar menenjit, meningoensefalit, myelit ve kraniyal sinir paralizileridir. Nörobruselloz vakalarında psikiyatrik tablolar (depresyon, amnezi, psikoz ve ajitasyon) rapor edilmiştir. Beyin omurilik sıvısının incelemesinde protein konsatrasyonu artmış, glukoz konsantrasyonu azalmış ve başlıca lenfositlerden oluşan orta derecede lökosit artışı mevcuttur. Brusella türlerinin beyin omurilik sıvısından izolasyonu düşük olduğundan nörobruselloz vakalarına en sık serolojik yöntemlerle tanı konulmaktadır. Tedavide doksisiklin, rifampisin, siprofloksasin, seftriakson ve trimetoprim-sülfame-taksazol tercih edilir. Etkili tedavi ile sinir sistemi hasarına bağlı sekel azalır. Anahtar kelimeler: Nörobruselloz, klinik tablolar, tedavi AbstractBrucellosis is an endemic zoonotic disease in our country and it is frequently transmitted to humans by ingestion of unpasteurised milk or milk products. Neurobrucellosis is a serious complication of brucellosis and may develop at any stage of disease. The clinical spectrum of neurobrucellosis classified as central and peripheral. The most frequent clinical presentations are meningitis, meningoencephalitis, myelitis and cranial nerve paralyses. The psychiatric manifestations (depression, amnesia, psychosis and agitation) were reported in neurobrucellosis cases. Examination of the cerebrospinal fluid an elevated protein concentration, a depressed glucose concentration and a moderate leukocytosis compodes mainly of lymphocytes. The isolation rate of Brucella species from cerebrospinal fluid is so low, most of the neurobrucellosis cases were diagnosed by serological methods. Doxycyclie, rifampin, ciprofloxacin, ceftriaxone and trimethoprim-sulfamethoxazole preferred in the treatment of neurobrucellosis. Effective treatment reduce the sequelae caused by nervous system damage.

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Section: Tanıunclassified

Neurobrucellosis

Tanyel

2017

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“…Central nervous system (CNS) involvement, although uncommon, is a serious complication of brucellosis. It has been reported in 1.7% -11% of patients with brucellosis [74][75][76][77][78]. Neurobrucellosis presents in a heterogeneous manner and the clinical manifestations and complications may include: fever, headache, nausea, vomiting, sweating, weakness, weight loss, back pain, neck stiffness, hearing loss, mental confusion, coma, convulsions, depression, dementia, papilledema, optic neuropathy, stroke, paraplegia, motor deficits, polyneuropathy, radiculopathy, cranial nerve palsies, pseudotumor cerebri, hydrocephalus, subarachnoidal hemorrhage, subdural hematoma, sagittal sinus thrombosis, intracranial vasculitis, spinal arachnoiditis, brain or paraspinal abscess, meningitis, encephalitis, transverse myelitis, hepatosplenomegaly and death [74][75][76][77][78].…”

Section: Neurobrucellosismentioning

confidence: 99%

“…Cerebrospinal fluid (CSF) analysis usually shows: lymphocytic pleocytosis, high protein, low glucose, positive cultures and positive CSF Brucella serology [74,75,77,78]. Computerized axial tomography etc.…”

Section: Neurobrucellosismentioning

confidence: 99%

“…(CAT) scans and MRI of brain and spinal cord may show: space occupying lesions such as granulomas or abscess formation and white matter lesions with demyelination [74,77,78]. Neurobrucellosis should be differentiated from: neurosyphilis, neurotuberculosis and other causes of purulent meningitis [75].…”

Section: Neurobrucellosismentioning

confidence: 99%

“…For Brucella meningitis, initially parenteral third generation cephalosporin such as ceftriaxone should be given, followed by various combinations of antimicrobials including: doxycycline, rifampicin, streptomycin or trimethoprim-sulfamethoxazole (TMP/ SMZ) [74,75,77]. The duration of antimicrobial therapy varies between 2 and 17 months with a median duration of 5 to 6 months [75][76][77].…”

Section: Neurobrucellosismentioning

confidence: 99%

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