Spinal cord compression due to brucella granuloma

Çeviker, Necdet; Baykaner, Kemali; Göksel, Murat; Sener, Levent; Alp, Hızır

doi:10.1007/bf01650713

Cited by 24 publications

(16 citation statements)

References 9 publications

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“…Los trastornos del sistema nervioso son complicaciones poco frecuentes (6) , aunque se ha reportado casos de meningitis, abscesos, granulomas (7,8) , y espondilitis (9) . Existen pocos casos publicados de síndrome de Guillain-Barré asociado a Brucelosis (Tabla 1).…”

Section: Discussionunclassified

Síndrome de Guillain Barré asociado a Brucelosis

Montalvo¹,

García²,

Ñavincopa³

et al. 2010

Rev Peru Med Exp Salud Publica

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RESUMENSe describe el caso de un varón de 47 años, con tiempo de enfermedad de dos días, caracterizado por pérdida de fuerza progresiva, simétrica y ascendente de miembros inferiores, se realizó punción lumbar luego de la tomografía cerebral y electromiografía lo cual evidenció polirradiculopatía motora pura con patrón axonal, compatible con el síndrome de Guillain Barré. Posteriormente, recibió cuatro sesiones de plasmaféresis, con mejoría clínica significativa desde la segunda sesión. Debido al antecedente epidemiológico se solicitó set para Brucellas, con rosa de Bengala positivo, se inició tratamiento antibiótico con rifampicina y doxiciclina, además de rehabilitación. Tres meses después el paciente mejoró completamente. La importancia del tratamiento temprano con plasmaféresis y determinar su diagnóstico etiológico hacen que el pronóstico del síndrome de Guillain Barré sea favorable.Palabras clave: Síndrome de Guillain Barré; Brucella; Enfermedades del sistema nervioso periférico (fuente: DeCS BIREME). GUILLAIN BARRÉ SYNDROME IN ASSOCIATION WITH BRUCELLOSIS ABSTRACTWe describe a case of a 47 years old male, with a history of 2 days of progressive, ascendant, symmetrical weakness in the lower extremities; a lumbar puncture was performed after the brain CT scan, as well as an electromyography, evidencing pure motor polyradiculopathy with axonal pattern, compatible with Guillain Barre syndrome. Afterwards, he received four plasmapheresis sessions, with clinical improvement from the second session. Due to his epidemiological background, Brucella set testing was done. Rose Bengal was positive, antibiotic treatment with rifampin and doxicicline was initiated, as well as rehabilitation. Three months later the patient recovered completely. The relevance of early treatment with plasmapheresis and the definition of the etiologic diagnosis determine that the prognosis of the Guillain Barre syndrome is favorable. INTRODUCCIÓNLa Brucelosis es una enfermedad infecciosa producida por cocobacilos Gram negativos aerobios inmóviles del género Brucella, tres especies son las más reconocidas como patógenos (mellitensis, abortus y suis) de las siete que se conocen a la fecha. Posee gran capacidad de sobrevivir en el interior de las células fagocíticas, lo que determina su característica clínica (1) .Las infecciones por Brucella están ocasionadas por la exposición directa o indirecta a los animales infectados (en zona urbana, a la ingesta de productos lácteos no pasteurizadas y, en zona rural, por contacto con animales enfermos). En el Perú se notifica anualmente más de 1000 casos de Brucellosis, la mayoría se deben a la infección por Brucella melitensis por consumo de queso de cabra proveniente de provincias vecinas a Lima.El periodo de incubación varía de una a tres semanas. La enfermedad puede afectar cualquier órgano o sistema y comienza con síntomas inespecíficos y polimorfos, a veces es asintomática. Generalmente se inicia con fiebre, escalofríos, malestar general, hiporexia, cefalea y artromialgias. Entre los sistemas m...

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Section: Discussionunclassified

Síndrome de Guillain Barré asociado a Brucelosis

Montalvo¹,

García²,

Ñavincopa³

et al. 2010

Rev Peru Med Exp Salud Publica

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“…[12][13][14]20) Myelopathy may also occur as a result of cord compression caused by extradural granuloma in the cervical and thoracic regions. 2,3,5,7,10,15,16,18) Previous cases of extradural spinal cord compression caused by brucellosis also occurred in the cervical (11 cases) and thoracic (7 cases) regions (Table 1). 2,3,5,7,10,16,18) Cord compression signs were common in all reported cases before radiological evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal cord compression due to brucellar epidural abscess is very rare, with only 18 previously reported cases. 2,3,5,7,10,16,18) Here we describe two cases of brucellar epidural abscess presenting with neurological deficits and discuss the treatment.…”

Section: Introductionmentioning

confidence: 97%

Spinal Epidural Abscess Caused by Brucellosis-Two Case Reports-

Ateş

Çaylı

Koçak

et al. 2005

Neurol. Med. Chir.(Tokyo)

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Brucellosis is still an important public health problem in the Mediterranean countries, including Turkey, and is most probably underdiagnosed or underreported. Two rare cases of extradural brucellar granuloma causing spinal cord compression in the thoracic and cervical regions were identified by magnetic resonance imaging. The abscesses were totally excised surgically. Medical treatment was given immediately after diagnosis, but delayed neurosurgical intervention resulted in partial neurological recovery in one patient although the other showed complete neurological recovery. Abscess formation may cause myelopathy due to extradural compression of the spinal cord. Failure to correct this condition may cause irreversible impairment of motor functions. Magnetic resonance imaging should be performed periodically in patients with brucellosis and suspected vertebral involvement to monitor for epidural granuloma formation and prevent extradural cord compression.

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“…Nervous system complications are rare, but cases of meningitis, 4 abscess development, 5 granulomas, 6,7 and spondylitis 8,9 have been reported in the literature. In endemic areas any suspicious nervous system symptom should be investigated for neurobrucellosis as it may easily be misdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

Neurobrucellosis and a demonstration of its involvement in spinal roots via magnetic resonance imaging

et al. 2003

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Objective: To present a neurobrucellosis case with spinal root involvement by means of magnetic resonance imaging (MRI). Methods: A case of neurobrucellosis resembling Guillain-Barre´syndrome is being reported. This case is unique in a way that spinal root involvement because of brucellosis was for the first time confirmed by MRI. Setting: Spinal cord unit of a rehabilitation and care center in Ankara, Turkey. Results: The correct diagnosis was made with cerebrospinal fluid culture. The patient showed a significant improvement with antimicrobial therapy and rehabilitation. Conclusion: Polyradiculopathy because of neurobrucellosis may mimic neurological syndromes. Rehabilitation should also be a part of its treatment.

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Spinal cord compression due to brucella granuloma

Cited by 24 publications

References 9 publications

Síndrome de Guillain Barré asociado a Brucelosis

Síndrome de Guillain Barré asociado a Brucelosis

Spinal Epidural Abscess Caused by Brucellosis-Two Case Reports-

Neurobrucellosis and a demonstration of its involvement in spinal roots via magnetic resonance imaging

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