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布氏杆菌病致格林-巴利综合征 1 例

A case of brucellosis-induced Guillain-Barre syndrome.

机构信息

Department of Infectious Diseases, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

BMC Infect Dis. 2022 Jan 20;22(1):72. doi: 10.1186/s12879-021-07025-3.

Abstract

BACKGROUND

Guillain-Barre syndrome (GBS) is a rare neurological complication of brucellosis, and neurobrucellosis is the most common, but they have many similarities in clinical manifestations. Many clinicians are accustomed to merely explaining the manifestations of nervous system involvement with neurobrucellosis, but they ignore the possibility of GBS, and this leads to misdiagnosis, untimely treatment, and serious consequences.

CASE PRESENTATION

A 55-year-old male patient was admitted to The First Affiliated Hospital of Harbin Medical University for intermittent fever, fatigue, and waist pain more than three months. Brucellosis was diagnosed from the blood test. Although anti-brucella treatment was given at the time of diagnosis, the disease continued to progress. At the time of the cerebrospinal fluid systematic physical examination and the neuroelectrophysiological test, acute motor sensory axonal neuropathy was diagnosed. The patient was given immediately administered immunoglobulin therapy. After three months of systemic treatment, the patient's muscle strength of the distal limbs gradually recovered. The numbness of the limbs eased slowly, and urination function and respiratory function returned to normal. He could sit by himself.

CONCLUSIONS

The possibility of GBS should be closely monitored for when a brucellosis patient shows typical clinical manifestations of progressive muscle weakness, protein-cell separation of the cerebral spinal fluid, and typical demyelinating sensorimotor polyneuropathy.

摘要

背景

吉兰-巴雷综合征(GBS)是布氏杆菌病罕见的神经系统并发症,神经布氏杆菌病最为常见,但两者在临床表现上有很多相似之处。许多临床医生习惯于仅仅用神经布氏杆菌病来解释神经系统受累的表现,而忽略了 GBS 的可能性,这导致误诊、治疗不及时和严重后果。

病例介绍

一名 55 岁男性患者因间歇性发热、乏力和腰痛超过三个月,入住哈尔滨医科大学附属第一医院。从血液检查中诊断出布氏杆菌病。尽管在诊断时给予了抗布氏杆菌治疗,但疾病仍在继续进展。在进行脑脊液系统体格检查和神经电生理检查时,诊断为急性运动感觉轴索性神经病。立即给予患者免疫球蛋白治疗。经过三个月的系统治疗,患者四肢远端肌力逐渐恢复。四肢麻木逐渐缓解,排尿功能和呼吸功能恢复正常,可自行坐立。

结论

当布氏杆菌病患者出现典型的进行性肌无力、脑脊液蛋白细胞分离和典型的脱髓鞘感觉运动多发性神经病时,应密切监测 GBS 的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/868f/8781241/c2996fbc6b22/12879_2021_7025_Fig1_HTML.jpg

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