Manipal Teaching Hospital, Pokhara, Nepal.
Multan Medical and Dental College, Multan, Pakistan.
J Med Case Rep. 2023 Mar 29;17(1):129. doi: 10.1186/s13256-023-03836-x.
Brucellosis is a zoonotic disease, caused by a Gram-negative coccobacillus of Brucella genus, transmitted to humans by animals, especially cattle. It rarely involves the nervous system (neurobrucellosis); only a few cases present with hearing loss. We report a case of neurobrucellosis, that presented with bilateral sensorineural hearing loss and mild to moderate persistent headache. To the best of our knowledge, this is the first well-documented case from Nepal.
The patient was a 40-year-old Asian male shepherd from the western mountainous region of Nepal who came to the emergency department of Manipal Teaching Hospital, Pokhara in May, 2018 and did a follow-up for 6 months. He presented with high-grade fever, profuse sweating, headache, myalgia, and bilateral sensorineural hearing loss. His history of consuming raw milk of cattle, symptoms including persistent mild to moderate headache, bilateral hearing loss, and serological findings were suggestive of neurobrucellosis. Following treatment, the symptoms improved, including the complete recovery of hearing loss.
Hearing loss may be the manifestation of neurobrucellosis. Physicians should know about such presentations in brucella endemic areas.
布鲁氏菌病是一种动物源性传染病,由布鲁氏菌属的革兰氏阴性球杆菌引起,通过动物(尤其是牛)传播给人类。它很少累及神经系统(神经布鲁氏菌病);只有少数病例出现听力损失。我们报告了一例神经布鲁氏菌病,表现为双侧感音神经性听力损失和轻度至中度持续性头痛。据我们所知,这是尼泊尔首例有记录的病例。
患者为来自尼泊尔西部山区的 40 岁亚洲男性牧羊人,于 2018 年 5 月前往尼泊尔博克拉的曼尼帕尔教学医院急诊科就诊,并进行了 6 个月的随访。他表现为高热、大量出汗、头痛、肌痛和双侧感音神经性听力损失。他有饮用生牛乳的病史,持续轻度至中度头痛、双侧听力损失以及血清学检查结果均提示神经布鲁氏菌病。经过治疗,症状得到改善,包括听力损失完全恢复。
听力损失可能是神经布鲁氏菌病的表现。在布鲁氏菌病流行地区,医生应该了解这些表现。