Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, USA.
Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, USA
BMJ Case Rep. 2020 Dec 21;13(12):e238216. doi: 10.1136/bcr-2020-238216.
Although uncommon, infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.
虽然不常见,但感染也可能发生在高流行地区以外,例如美国。在美国南部,猎捕野猪的人有感染布氏杆菌病的风险。我们报告了一例发热、头痛和全身症状持续 11 个月的患者。他被诊断为神经型布氏杆菌病。该患者经静脉注射头孢曲松、口服多西环素和利福平治疗后成功治愈。他在完成治疗后仍有持续性神经后遗症。本病例说明在非流行地区诊断神经型布氏杆菌病需要高度怀疑,因为最初的症状可能不明显。该疾病可以成功治疗,但常见持续性神经后遗症。