Abdinia Babak, Barzegar Mohammad, Malaki Majid, Behbod Haleh, Oskoui Shahram
Assistant Professor, Pediatric Health Research Center, Departments of Infectious diseases, Tabriz University of Medical Sciences, Tabriz, Iran.
Professor of Pediatric Neurology, Departments of Pediatric Neurology, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Child Neurol. 2013 Winter;7(1):35-8.
Brucellosis is an endemic zoonosis in Iran. It is a systemic infection that can involve any organs or systems of the body and have variable presentations. Ventriculoperitoneal (VP) shunt infections due to brucellosis have been rarely reported in the literatures. This is the history of a four years old boy who developed Brucella meningoencephalitis at the age of 42 months, whilst he had a VP shunt in situ for hydrocephalus treatment. Also, he presented brucellosis as acute abdomen. This patient was treated with trimethoprim-sulfamethoxazole, gentamicin and rifampicin. The shunt was extracted and all clinical and laboratory test abnormalities subsided through this management. We propose that in a patient with Brucella meningoencephalitis, the cerebrospinal fluid shunt system can be extracted and treatment with appropriate combination of antibiotics could be successful. Moreover, it shows that brucellosis should be considered in the differential diagnosis for acute abdomen and ascites in endemic regions.
布鲁氏菌病是伊朗的一种地方性人畜共患病。它是一种全身性感染，可累及身体的任何器官或系统，表现多样。文献中很少报道布鲁氏菌病导致的脑室腹腔（VP）分流感染。这是一名4岁男孩的病史，他在42个月大时患上布鲁氏菌性脑膜脑炎，当时因脑积水正在接受VP分流治疗。此外，他还以急腹症形式表现出布鲁氏菌病。该患者接受了甲氧苄啶-磺胺甲恶唑、庆大霉素和利福平治疗。分流装置被取出，通过这种治疗，所有临床和实验室检查异常均消失。我们建议，对于患有布鲁氏菌性脑膜脑炎的患者，可以取出脑脊液分流系统，适当联合使用抗生素治疗可能会取得成功。此外，这表明在流行地区，急性腹痛和腹水的鉴别诊断中应考虑布鲁氏菌病。
