Bouza E, García de la Torre M, Parras F, Guerrero A, Rodríguez-Créixems M, Gobernado J
Infectious Diseases Unit (Microbiology Service), Hospital Ramón y Cajal, Madrid, Spain.
Rev Infect Dis. 1987 Jul-Aug;9(4):810-22. doi: 10.1093/clinids/9.4.810.
Neurobrucellosis develops in less than 5% of cases of systemic brucellosis; however, most patients with neurobrucellosis have meningeal involvement. Seven new cases of brucellar meningitis and 17 cases from the Spanish- and English-language medical literature are analyzed in terms of epidemiologic data, clinical manifestations, laboratory results for cerebrospinal fluid and serum, treatment, and course of the disease. Brucellar meningitis mimics other neurologic and non-neurologic conditions, and its diagnosis is only suggested in the presence of adequate epidemiologic information. Isolation of Brucella from the cerebrospinal fluid is uncommon. Treatment is accomplished with the combination of tetracycline or doxycycline and streptomycin, rifampin, or both. Mean length of therapy in the seven new cases was 8.5 months. Brucellar meningitis has a better prognosis than other forms of chronic meningitis, and mortality is low for reasons that are not clear; however, the incidence of minor sequelae is high.
神经型布鲁氏菌病在系统性布鲁氏菌病病例中发生率不到5%；然而，大多数神经型布鲁氏菌病患者有脑膜受累情况。对7例新的布鲁氏菌性脑膜炎病例以及西班牙语和英语医学文献中的17例病例，从流行病学数据、临床表现、脑脊液和血清实验室检查结果、治疗及病程等方面进行了分析。布鲁氏菌性脑膜炎可模仿其他神经和非神经疾病，只有在有充分流行病学信息时才会考虑其诊断。从脑脊液中分离出布鲁氏菌的情况并不常见。治疗采用四环素或强力霉素与链霉素、利福平联合使用，或两者并用。7例新病例的平均治疗时长为8.5个月。布鲁氏菌性脑膜炎的预后比其他形式的慢性脑膜炎要好，死亡率较低，原因不明；然而，轻微后遗症的发生率较高。
