Multiple Cranial Nerve Involvement Caused by Brucella melitensis

Şahin, Elif; Yılmaz, Arda; Ersöz, Gülden; Uğuz, Mustafa; Kaya, Ali Hakan

doi:10.1097/smj.0b013e3181ac0628

Cited by 19 publications

(11 citation statements)

References 12 publications

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“…Slightly more than one-fifth of the patient population experienced cranial nerve involvement, most of which occurred before the start of antibiotic treatment. Cranial nerve involvement in neurobrucellosis is quite frequent, and multiple lesions in the same patient were recorded (21). Similarly, polyneuropathy and paresis were the most frequent complications seen in up to one-fourth of our patients.…”

Section: Discussionmentioning

confidence: 90%

Efficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Study

Erdem

Ulu-Kılıç

Kılıç

et al. 2012

Antimicrob Agents Chemother

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No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 ؎ 2.47 months in P1, 6.52 ؎ 4.15 months in P2, and 5.18 ؎ 2.27 months in P3) (P ‫؍‬ 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n ‫؍‬ 5/166, 3.0%) and the oral therapy (n ‫؍‬ 4/42, 9.5%) (P ‫؍‬ 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n ‫؍‬ 6/166 [3.6%] versus n ‫؍‬ 6/42 [14.3%]; P ‫؍‬ 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n ‫؍‬ 6/42) compared to P1 (2.6%, n ‫؍‬ 3/117) and P3 (6.1%, n ‫؍‬ 3/49) (P ‫؍‬ 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.

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Section: Discussionmentioning

confidence: 90%

Efficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Study

Erdem

Ulu-Kılıç

Kılıç

et al. 2012

Antimicrob Agents Chemother

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“…6th cranial nerve is the most frequently involved cranial nerve in case reports from Turkey, followed by 7th and 8th [11,12]. There are a few case reports of isolated cranial nerve involvement due to brucellosis in adults in the literature [13][14][15][16]. Neurological complications of brucellosis in adults have been classified in two groups.…”

Section: Discussionmentioning

confidence: 99%

Bilateral abducens nerve palsy during treatment of a pediatric brucellosis

Çay¹

2020

Ann Clin Anal Med

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Brucellosis is a multisystemic zoonosis caused by the bacteria of the genus Brucella particles or direct contact with infected animal parts. Due to the involvement of various organ systems, its clinical spectrum is wide. Neurobrucellosis occurs in 3-13% of all brucellosis cases and rarer in children. Involvement of various cranial nerves may be seen very rarely as a component of neurobrucellosis. We present here a case of a 3-year-old girl with sixth cranial nerve palsy that occurred during treatment for brucellosis. Our patient is the first pediatric neurobrucellosis case with isolated 6th nerve palsy in English-language literature. Neurobrucellosis should be considered in the differential diagnosis of patients of any age with unexplained neurological symptoms living in endemic regions

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“…Sever infection of human brucellosis can cause a range of symptoms and injury of central nervous system, liver, and spleen occur (Collier et al, 1998). Sahin et al (2009) reported a case of neurobrucellosis which complicated by optic obducens and vestibulocochlear nerve palsies due to B.melitensis infection. In a study which was conducted by Young and Suvannoparrat (1975), six cases of B. melitensis infections, that the common etiologic factor was, the ingestion of raw goat cheese, were reported, in which liver cell dysfunction and diffuse hepatitis was present in each case.…”

Section: Resultsmentioning

confidence: 99%

The prevalence of Brucella abortus and Brucella melitensis in local cheese produced in Sarab city, Iran and its public health implication

Akbarmehr¹

2011

Afr. J. Microbiol. Res.

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Brucellosis is an infectious disease caused by different species of Brucella. The main sources of human brucellosis for general population are dairy products prepared from raw milk. The aim of this study was to determine the prevalence of Brucella abortus and Brucella melitensis in unpasteurized cheese produced in Sarab city. For this purpose, a total of 1000 cheese samples were collected from Sarab city and its rural area from September 2006 till September 2007. Samples were cultured on selective Brucella agar and incubated at 37°C for a period of 2 weeks. Brucella species were confirmed by biochemical tests and then serological screening was performed by specific Brucella antisera. Overal, among 1000 samples which were examined by bacteriological tests, Brucella organisms were isolated from 22 samples (2.2%), seven of which (0.7%) were B. melitensis and the rest 15 positive samples (1.5%) were B. abortus. The prevalence rates of Brucella organisms in examined cheese samples in autumn, winter, spring, and summer were determined 2.42, 1.39, 2.5 and 2.62% respectively. This study revealed the public health hazard of local cheese produced in Sarab city.

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Multiple Cranial Nerve Involvement Caused by Brucella melitensis

Cited by 19 publications

References 12 publications

Efficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Study

Efficacy and Tolerability of Antibiotic Combinations in Neurobrucellosis: Results of the Istanbul Study

Bilateral abducens nerve palsy during treatment of a pediatric brucellosis

The prevalence of Brucella abortus and Brucella melitensis in local cheese produced in Sarab city, Iran and its public health implication

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