Akbayram S, Dogan M, Peker E, Bektas M S, Caksen H, Karahocagil M
Department of Pediatrics, Yuzuncu Yil University, Van, Turkey.
Bratisl Lek Listy. 2012;113(7):424-30. doi: 10.4149/bll_2012_096.
Brucellosis is an endemic disease in many areas throughout the world. Central nervous system involvement is a serious complication of brucellosis with a ratio of 4-11% of all patients.
to describe our experience in diagnosis, treatment, and outcome of 25 pediatric patients with neurobrucellosis.
This study included a review of medical records of patients who were diagnosed with neurobrucellosis between March 2001 and March 2009. Patients who had both clinical findings consistent with neurobrucellosis and positive microbiologic/serologic examinations of CSF with abnormal CSF findings were enrolled in the study.
The study included 25 patients between 1 and 15 years of age (mean 8.8 years), while 15 were males and 10 were females. Most of the patients (52 %) were in the age group of 5-9 years with male predominance. The distribution of cases showed density in June and February. The most commonly presented complaints were headache, fever and sweating while the most commonly observed findings were fever and meningeal irritation signs. All patients had positive cerebrospinal fluid agglutination test for brucellosis. Four different regimens were used based on ceftriaxone, doxycycline, cotrimoxasole, streptomycin, and rifampicin. One patient died, three patients were discharged with sequel, and the remaining patients (84 %) were discharged with full recovery.
Clinicians, especially those providing health services in endemic areas like Turkey, should keep in mind that neurobrucellosis can be involved in patients with unexplained symptoms like memory impairment or in patients diagnosed with meningitis (Tab. 5, Fig, 2, Ref. 39).
布鲁氏菌病是世界上许多地区的一种地方病。中枢神经系统受累是布鲁氏菌病的一种严重并发症，在所有患者中的比例为4% - 11%。
描述我们对25例小儿神经型布鲁氏菌病患者的诊断、治疗及预后经验。
本研究回顾了2001年3月至2009年3月期间诊断为神经型布鲁氏菌病患者的病历。具有与神经型布鲁氏菌病相符的临床表现且脑脊液微生物学/血清学检查阳性且脑脊液检查结果异常的患者纳入本研究。
该研究纳入了25例年龄在1至15岁之间（平均8.8岁）的患者，其中15例为男性，10例为女性。大多数患者（52%）在5至9岁年龄组，以男性为主。病例分布在6月和2月较为密集。最常见的主诉是头痛、发热和出汗，而最常观察到的体征是发热和脑膜刺激征。所有患者脑脊液布鲁氏菌凝集试验均为阳性。基于头孢曲松、多西环素、复方新诺明、链霉素和利福平使用了四种不同的治疗方案。1例患者死亡，3例患者出院时有后遗症，其余患者（占84%）出院时完全康复。
临床医生，尤其是在土耳其等地方病流行地区提供医疗服务的医生，应牢记神经型布鲁氏菌病可能累及有记忆障碍等不明原因症状的患者或诊断为脑膜炎的患者（表5，图2，参考文献39）。
