Gouider R, Samet S, Triki C, Fredj M, Gargouri A, el Bahri F, Ben Ghorbel I, Kasraoui A, Mhiri C, Mrabet A
Service de Neurologie, EPS Charles Nicolle, Tunisie.
Rev Neurol (Paris). 1999 Mar;155(3):215-8.
Eight patients presented neurological signs secondary to Brucella infection. The clinical presentation was a meningoencephalitis in three cases, a meningoencephalomyelitis in one case, an epiduritis with spinal cord compression in one case, an acute polyradiculoneuritis in two cases and a chronic polyradiculoneuritis in one case. Acoustic nerve was impaired in seven cases. Cerebrospinal fluid (CSF) analysis revealed a lymphocytic meningitis and a high protein concentration in all cases. The agglutination test titers were elevated in the serum and in the CSF of seven patients (> or = 1/80) and two patients respectively. Brucella melitensis culture was disclosed in the blood of one patient and in the CSF of two patients. Three patients were treated by the association cycline and rifampicin whereas a tritherapy including cycline, rifampicin and TMP-SMZ was used in the other cases. Outcome was favorable in seven cases. This study outlines the polymorphism of neurological manifestations due to brucellosis, even in familial cases and this diagnostic must be especially done in Middle East and South Mediterranean countries.
8例患者出现布鲁氏菌感染继发的神经症状。临床表现为3例脑膜脑炎、1例脑膜脑脊髓炎、1例伴有脊髓压迫的硬脊膜炎症、2例急性多发性神经根神经炎和1例慢性多发性神经根神经炎。7例患者听神经受损。脑脊液(CSF)分析显示所有病例均为淋巴细胞性脑膜炎且蛋白浓度升高。7例患者血清和2例患者脑脊液中的凝集试验滴度升高(≥1/80)。1例患者血液和2例患者脑脊液中培养出羊种布鲁氏菌。3例患者接受四环素和利福平联合治疗,其他病例采用包括四环素、利福平及复方磺胺甲恶唑的三联疗法。7例患者预后良好。本研究概述了布鲁氏菌病所致神经表现的多态性,即使在家族性病例中也是如此,并且在中东和南地中海国家必须特别进行这种诊断。