Vafaeimanesh Jamshid, Shahamzeh Alireza, Bagherzadeh Mohammad
Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran.
Gastrointestinal and liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2017 Spring;8(2):119-122. doi: 10.22088/cjim.8.2.119.
Brucellosis is a zoonotic infection which is endemic in many countries. It is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of brucellosis.
A 25-year-old woman with a history of lupus for 5 months referred to the emergency ward of Shahid Beheshti Hospital of Qom due to vertigo, drop attack and a convulsion episode from the previous day. She was unable to move at initial evaluation, and her upper and lower extremities were spastic. She had blurred vision one day after admission. Based on her past history and suspecting neurological pulmonary presentations, treatment with immunosuppressive drugs was started and brain MRI was performed. According to the MRI mode and endemic area, neurobrucellosis was suspected and 2ME and Wright tests were performed. Wight test was 1.5120 while 2ME test was 1.640 which were strongly positive. So, with neurobrucellosis diagnosis, the patient was treated but unfortunately 4 days later, after respiratory apnea, she was pronounced dead.
In endemic areas for brucellosis, neurobrucellosis should always be kept in mind in the differential diagnosis of neurological and psychiatric cases that are encountered.
布鲁氏菌病是一种人畜共患感染病，在许多国家呈地方性流行。它是一种多系统疾病，可能表现出广泛的临床表现和并发症。神经型布鲁氏菌病是布鲁氏菌病的一种罕见并发症。
一名25岁女性，有5个月狼疮病史，因前一天出现眩晕、跌倒发作和抽搐发作，被转诊至库姆市沙希德·贝赫什提医院急诊科。初始评估时她无法活动，上下肢痉挛。入院一天后出现视力模糊。根据其既往病史并怀疑有神经肺部表现，开始使用免疫抑制药物治疗并进行脑部磁共振成像（MRI）检查。根据MRI结果和流行地区，怀疑为神经型布鲁氏菌病，并进行了2-巯基乙醇（2ME）试验和wright试验。wright试验结果为1.5120，2ME试验结果为1.640，均为强阳性。因此，确诊为神经型布鲁氏菌病后对患者进行了治疗，但不幸的是，4天后，患者因呼吸暂停被宣告死亡。
在布鲁氏菌病流行地区，对于遇到的神经和精神病例进行鉴别诊断时，应始终考虑神经型布鲁氏菌病。
