Iran J Child Neurol. 2014 Spring;8(2):65-9.
Brucellosis is a multi-system infectious disease that presents with various manifestations and complications. Neurobrucellosis is an uncommon but serious presentation of brucellosis that can be seen in all stages of the disease. High index of suspicion, especially in endemic areas is essential to prevent morbidity from this disease. The case was an 11- year -old female patient who was admitted with a severe headache that was worsening over a period of 2 months. The day after each attack, she experienced transient right hemiparesia that was lasting less than one hour (TIA) as well as blurred vision and bilateral papilledema. Laboratory findings revealed serum agglutination Wright test positive at 1/320 and 2ME test positive at 1/160. A lumbar puncture showed a clear CSF with increased opening pressure (32 cmH2O), CSF examination was within normal range (pseudotumor cerebri).To our knowledge, there has been no report for recurrent TIA in pediatric neurobrucellosis in the base of pseudotumor cerebri. In endemic areas like Iran, unexplained neurological signs or symptoms should be evaluated for brucellosis.
布鲁氏菌病是一种多系统传染病,有多种表现形式和并发症。神经型布鲁氏菌病是布鲁氏菌病的一种罕见但严重的表现形式,可在疾病的各个阶段出现。高度怀疑,尤其是在流行地区,对于预防这种疾病的发病至关重要。该病例为一名11岁女性患者,因严重头痛入院,头痛在2个月内逐渐加重。每次发作后的第二天,她会出现持续不到一小时的短暂性右侧偏瘫(短暂性脑缺血发作)以及视力模糊和双侧视乳头水肿。实验室检查结果显示血清凝集试验(Wright试验)1/320呈阳性,2-巯基乙醇试验(2ME试验)1/160呈阳性。腰椎穿刺显示脑脊液清澈,初压升高(32cmH₂O),脑脊液检查在正常范围内(假脑瘤)。据我们所知,在假脑瘤基础上的小儿神经型布鲁氏菌病复发性短暂性脑缺血发作尚无报告。在伊朗等流行地区,对于不明原因的神经体征或症状,应评估是否为布鲁氏菌病。