Türel Ozden, Sanli Kamuran, Hatipoğlu Nevin, Aydoğmuş Ciğdem, Hatipoğlu Hüsem, Siraneci Rengin
Department of Pediatrics, Bakirköy Maternity and Children's Hospital, Istanbul, Turkey.
Turk J Pediatr. 2010 Jul-Aug;52(4):426-9.
The involvement of the central nervous system (CNS) in brucellosis is rare and has a broad range of presentations. Subacute and chronic meningoencephalitis are described as the most common neurologic manifestations. We report a six-year-old boy with culture-proven neurobrucellosis who presented with an acute picture of meningoencephalitis. Cerebrospinal fluid (CSF) analysis revealed pleocytosis with slight elevation of protein. The agglutination test titer was elevated in serum and Brucella spp. were isolated from both blood and CSF. He was treated with trimethoprim-sulfamethoxazole plus rifampin and streptomycin. His clinical and laboratory features improved with specific antibiotic therapy and no sequela was observed in the short-term follow-up. Due to protean clinical features, unfamiliarity with the disease can delay the diagnosis in children who are not occupationally exposed. In endemic areas, neurobrucellosis should be considered in the evaluation of patients with unexplained neurologic symptoms.
布鲁氏菌病累及中枢神经系统（CNS）的情况罕见，且临床表现多样。亚急性和慢性脑膜脑炎被描述为最常见的神经学表现。我们报告一名6岁经培养证实为神经型布鲁氏菌病的男孩，其呈现出急性脑膜脑炎的症状。脑脊液（CSF）分析显示有细胞增多且蛋白略有升高。血清凝集试验滴度升高，血液和脑脊液中均分离出布鲁氏菌属。他接受了甲氧苄啶 - 磺胺甲恶唑联合利福平及链霉素治疗。经过特异性抗生素治疗，其临床和实验室特征有所改善，短期随访未观察到后遗症。由于临床表现多样，对于无职业暴露史的儿童，不熟悉该疾病会导致诊断延迟。在流行地区，对不明原因神经症状的患者进行评估时应考虑神经型布鲁氏菌病。
