Pappas Georgios, Akritidis Nikolaos, Christou Leonidas
Institute of Continuing Medical Education of Ioannina, H, Trikoupi 10, Ioannina 45333, Greece.
Expert Rev Anti Infect Ther. 2007 Dec;5(6):983-90. doi: 10.1586/14787210.5.6.983.
Neurological involvement is one of the most perplexing and diverse presentation complications of brucellosis, a worldwide prevalent zoonosis. This review presents the current knowledge available from medical literature and discusses the shortcomings of the existing data. A proposed regimen should include doxycycline and rifampicin and, with the benefit of doubt, ceftriaxone, since its high concentration in the cerebrospinal fluid may offer significant efficacy against the pathogen. Corticosteroids have been used in specialized situations. The use of streptomycin is discouraged owing to its questionable ability to penetrate into the cerebrospinal fluid and its potential neurotoxicity that may perplex the clinical presentation. Treatment duration should be individualized in the absence of an adequate cut-off index.
神经受累是布鲁氏菌病最复杂多样的并发症之一，布鲁氏菌病是一种全球流行的人畜共患病。本综述介绍了医学文献中的现有知识，并讨论了现有数据的不足之处。建议的治疗方案应包括多西环素和利福平，在存在疑问的情况下，还应使用头孢曲松，因为其在脑脊液中的高浓度可能对病原体具有显著疗效。皮质类固醇已用于特殊情况。不鼓励使用链霉素，因为其穿透脑脊液的能力存疑，且可能具有潜在神经毒性，这可能会使临床表现复杂化。在缺乏适当截断指标的情况下，治疗持续时间应个体化。
