Gul Hanefi Cem, Erdem Hakan, Gorenek Levent, Ozdag Mehmet Fatih, Kalpakci Yasin, Avci Ismail Yasar, Besirbellioglu Bulent Ahmet, Eyigun Can Polat
Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Hospital, Ankara, Turkey.
Intern Med. 2008;47(11):995-1001. doi: 10.2169/internalmedicine.47.0866. Epub 2008 Jun 2.
The central nervous system involvement of Brucellosis causes a hard to treat infection with multiple sequelae. The aim of this paper is to discuss the course of neurobrucellosis in response to therapy.
Patients with neurobrucellosis were evaluated. The diagnosis was established by the isolation of bacteria, abnormal CSF findings and positive serology. Ceftriaxone, rifampicin, doxycycline and trimethoprim sulfamethoxazole were the antibiotic choices for these cases.
We present 11 cases with neurobrucellosis. None of our patients died, albeit one case has a critical situation due to subarachnoid hemorrhage and its' concordant sequelae. Only one of four patients with walking difficulty and two with hearing loss were normalized with therapy. Imaging techniques did not provide any specific contribution regarding the Brucella infection.
Parenteral ceftriaxone should be used as an initial alternative in the management of neurobrucellosis. Although the therapy should be individualized, the duration of therapy should be a minimum of six months with suitable antibiotics.
布鲁氏菌病累及中枢神经系统会导致难以治疗的感染并引发多种后遗症。本文旨在探讨神经型布鲁氏菌病的治疗过程。
对神经型布鲁氏菌病患者进行评估。通过细菌分离、脑脊液检查异常及血清学阳性来确诊。头孢曲松、利福平、多西环素和复方新诺明是这些病例的抗生素选择。
我们呈现了11例神经型布鲁氏菌病患者。尽管有1例因蛛网膜下腔出血及其相关后遗症而处于危急状态，但我们的患者均无死亡。治疗后，4例行走困难患者中仅1例恢复正常，2例听力损失患者中也仅1例恢复正常。影像学技术对布鲁氏菌感染未提供任何特异性帮助。
在神经型布鲁氏菌病的治疗中，应将静脉注射头孢曲松作为初始选择。尽管治疗应个体化，但使用合适的抗生素治疗时间应至少为6个月。
