Meshref Mostafa, Amro Yara, Ebada Mahmoud Ahmed
Department of Neurology, King Khaled Hospital, Hail. Saudi Arabia.
Suzanne Mubarak Specialized Health Center, Syeda Zainab, Cairo. Egypt.
Recent Pat Antiinfect Drug Discov. 2020 Sep 17. doi: 10.2174/1574891X15999200917153454.
Brucellosis is a highly infectious multi-systemic zoonosis, and it is caused by Gram-negative bacteria, Brucella. Despite the low incidence of neurobrucellosis, it is the most dangerous consequence of brucellosis.
A 30-year-old Sudanese male patient presented to our hospital with a complaint of fever associated with confusion for three days. He had signs of meningeal irritation in the form of neck stiffness, positive Kernig's, and Lesage's sign. The computerized tomography of the brain was normal. The CSF analysis showed a clear colorless sample with normal tension, decreased glucose, and slightly increased CSF protein level. We reviewed his occupational history; the patient was a farmer with regular contact with cattle and camels. The patient had positive Brucella antibodies for both B.Abortus and B. melitensis with a high titer (1/640). As described in various patents, we administrated triple therapy for brucellosis for two weeks. A marked improvement of the conscious level was observed, and the patient was back to normal within a few days post-treatment.
We encourage physicians to consider the diagnosis of neurobrucellosis with any neurologic sign without a known cause. Our case highlights the importance of occupational history in clinical medicine.
布鲁氏菌病是一种具有高度传染性的多系统人畜共患病，由革兰氏阴性菌布鲁氏菌引起。尽管神经型布鲁氏菌病发病率较低，但却是布鲁氏菌病最危险的后果。
一名30岁的苏丹男性患者因发热伴意识模糊三天前来我院就诊。他有脑膜刺激征，表现为颈部僵硬、克尼格征阳性和勒萨热征阳性。脑部计算机断层扫描结果正常。脑脊液分析显示样本清澈无色，压力正常，葡萄糖降低，脑脊液蛋白水平略有升高。我们询问了他的职业史；该患者是一名农民，经常接触牛和骆驼。该患者抗流产布鲁氏菌和羊种布鲁氏菌的抗体均呈高滴度阳性（1/640）。按照各种病例中的描述，我们对布鲁氏菌病进行了为期两周的三联疗法治疗。观察到意识水平有明显改善，患者在治疗后几天内恢复正常。
我们鼓励医生在遇到任何无已知病因的神经系统体征时考虑神经型布鲁氏菌病的诊断。我们的病例突出了职业史在临床医学中的重要性。
