Hakamifard Atousa, Naghibi Seyed Navid, Hashemi Fesharaki Seyed Sohrab
Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Neurology, Kashani Hospital Epilepsy Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2019 Jul 5;10:119. doi: 10.4103/ijpvm.IJPVM_417_18. eCollection 2019.
Brucellosis is a common zoonotic infection caused by bacterial genus , a Gram-negative bacterium, and continued to be a health problem in endemic areas. Anti--methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune disease which can lead to status epilepticus. A 19-year-old male patient was referred to our hospital with status epilepticus. The diagnosis of brucellosis was confirmed about 2 weeks before. The brain magnetic resonance imaging was normal. Lumbar puncture was performed, and cerebral spinal fluid (CSF) was in normal limits. The patient was treated with antiepileptic, anti-brucellosis agents. Two weeks after discharge, the patient readmitted to hospital with status epilepticus again. Extensive workup was negative except that NMDAR antibodies were detected in serum and CSF. The diagnosis of anti-NMDAR encephalitis was established. Brucellosis as a triggering factor for NMDAR encephalitis should be considered.
布鲁氏菌病是一种由革兰氏阴性菌布鲁氏菌属引起的常见人畜共患感染病，在流行地区仍然是一个健康问题。抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎是一种可导致癫痫持续状态的自身免疫性疾病。一名19岁男性患者因癫痫持续状态被转诊至我院。布鲁氏菌病的诊断约在两周前得到证实。脑部磁共振成像正常。进行了腰椎穿刺，脑脊液（CSF）在正常范围内。患者接受了抗癫痫、抗布鲁氏菌病药物治疗。出院两周后，患者再次因癫痫持续状态入院。除血清和脑脊液中检测到NMDAR抗体外，广泛的检查均为阴性。抗NMDAR脑炎的诊断得以确立。应考虑布鲁氏菌病作为NMDAR脑炎的触发因素。
