Shah Irfan Ahmad, Kawoos Yuman, Sanai Bashir Ahmad, Rabyang Stanzen, Banday Dawood
Department of Neurology, Government Medical College, Superspeciality Hospital, Srinagar, Jammu and Kashmir, India.
Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India.
J Neurosci Rural Pract. 2018 Oct-Dec;9(4):644-646. doi: 10.4103/jnrp.jnrp_16_18.
A 45-year-old female without any past or family history of psychiatric illness presented to the emergency department with complaints of abnormal behavior, irrelevant talking, restlessness, episodic crying, and decreased sleep of 2-day duration. On detailed interview, the attendants gave a history of an intermittent headache of 6-month duration and hearing impairment of 4-month duration. On investigation, her cerebrospinal fluid was reactive, and brucella titers were positive. She received appropriate treatment for 6 months and a short course of antipsychotics. Her symptoms settled, but she had persistent hearing loss. Psychosis as well as hearing loss is a very rare presentation of brucellosis. The case highlights the importance of considering neurobrucellosis as a differential diagnosis in patients with any unexplained neuropsychiatric symptoms such as acute psychosis or hearing loss.
一名45岁女性,既往无精神疾病史,家族中也无精神疾病史,因异常行为、言语紊乱、烦躁不安、阵发性哭泣及睡眠减少2天而就诊于急诊科。详细询问病史时,家属称患者有持续6个月的间歇性头痛及持续4个月的听力减退。检查发现,她的脑脊液呈阳性反应,布鲁氏菌滴度为阳性。她接受了6个月的适当治疗及短期抗精神病药物治疗。她的症状得到缓解,但仍存在持续性听力损失。精神病及听力损失是布鲁氏菌病非常罕见的表现形式。该病例凸显了在有任何无法解释的神经精神症状(如急性精神病或听力损失)的患者中,将神经型布鲁氏菌病作为鉴别诊断的重要性。