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Evaluation of the clinical presentations in neurobrucellosis

机译:评价神经布鲁氏菌病的临床表现

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Background Brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is one of the complications. ; Methods In this study, we describe our experience in the diagnosis, treatment, and the final outcomes of 20 patients with neurobrucellosis out of 305 patients with brucellosis, within a five-year period between January 1999 and June 2004. ; Results The rate of neurobrucellosis was 6.6%. Twelve males and eight females with a mean age of 37.4 years were investigated. Fever, headache, confusion, and gait disorders were the main complaints. The duration of their complaints varied between one week and six months. On physical examination, 13 patients had fever, six had neck stiffness and confusion, three had motor deficit on either their upper or lower extremities, and four of them had diplopia. The Rose-Bengal test and standard tube agglutination tests were positive in all of the patients. Brucella melitensis was isolated from the blood of six of the 20 (30%) patients. Cerebrospinal fluid (CSF) was analyzed in 18 patients. Pleocytosis with a mean value of 244×106 cells/L, and high protein levels were detected in all. A low glucose level in the CSF was detected in ten patients. Patients were treated medically and a complete resolution was achieved in all. ; Conclusion Patients with a Brucella infection occasionally manifest central nervous system involvement. Clinicians, especially serving in endemic areas or serving patients coming from endemic areas should consider the likelihood of neurobrucellosis in the patients with unexplained neurological and psychiatric symptoms, and should perform the necessary tests on blood and CSF.
机译:背景布鲁氏菌病是一种多系统疾病,可能表现出广泛的临床表现和并发症。神经布鲁氏菌病是并发症之一。 ;方法在本研究中,我们描述了我们在1999年1月至2004年6月的5年中,对305例布鲁氏菌病患者中20例神经布鲁氏菌病患者的诊断,治疗和最终结果的经验。结果神经布鲁菌病发生率为6.6%。调查了十二名男性和八名女性,平均年龄为37.4岁。发烧,头痛,神志不清和步态障碍是主要的不适。他们的投诉持续时间在一周到六个月之间。体检中,有13例发烧,6例有颈部僵硬和意识模糊,3例上肢或下肢运动障碍,其中4例患有复视。 Rose-Bengal试验和标准管凝集试验在所有患者中均为阳性。从20名患者中的6名(30%)的血液中分离出布鲁氏菌。分析了18例患者的脑脊液(CSF)。均检测出平均为244×10 6 细胞/ L的细胞增多,蛋白水平高。在十名患者中发现脑脊液中葡萄糖水平低。对患者进行了药物治疗,所有患者均获得了完全解决。 ;结论布鲁氏菌感染患者偶尔会出现中枢神经系统受累。临床医生,尤其是在流行地区或在流行地区服务的患者,应考虑具有无法解释的神经和精神症状的患者发生神经布鲁氏菌病的可能性,并应对血液和脑脊液进行必要的检查。

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