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揭示神经型布鲁氏菌病:一例强调早期诊断以获更佳预后的病例报告。

Unveiling Neurobrucellosis: A Case Report Emphasizing Early Diagnosis for Better Outcomes.

作者信息

Haripriya Sivakumar, Malhotra Shikhir, Gadepalli Ravisekhar, Tak Vibhor, Kumar Bharat

机构信息

Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India.

Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India.

出版信息

Access Microbiol. 2024 Feb 13;6(2). doi: 10.1099/acmi.0.000705.v3. eCollection 2024.

Abstract

INTRODUCTION

Brucellosis is a pervasive zoonotic disease causing considerable human morbidity worldwide. This report focuses on a case of neurobrucellosis in a rural Indian patient, emphasizing the need for timely microbiological confirmation given its nonspecific clinical presentation.

CASE PRESENTATION

A 55-year-old rural Indian farmer presented with a 3 week history of insidious, low-grade fever, myalgia, and arthralgia. He developed acute right-sided weakness and neurological symptoms, including disorientation and neck rigidity. Laboratory tests indicated abnormal blood counts, elevated inflammatory markers, and liver dysfunction. Cerebrospinal fluid analysis showed pleocytosis with lymphomononuclear cells and elevated protein levels. Blood cultures eventually grew Gram-negative coccobacilli. Serological tests confirmed neurobrucellosis. Prompt antibiotic therapy led to clinical and laboratory improvement.

CONCLUSION

This case underscores the importance of recognizing neurobrucellosis, particularly in endemic areas, given its nonspecific clinical presentation. Early microbiological diagnosis, supported by positive blood cultures and serological tests, was crucial. The patient's rapid response to appropriate antibiotics emphasizes the significance of timely recognition and management.

摘要

引言

布鲁氏菌病是一种广泛存在的人畜共患病,在全球范围内导致相当多的人类发病。本报告重点关注一名印度农村患者的神经型布鲁氏菌病病例,鉴于其非特异性临床表现,强调及时进行微生物学确诊的必要性。

病例介绍

一名55岁的印度农村农民,有3周隐匿性低热、肌痛和关节痛病史。他出现急性右侧肢体无力及神经症状,包括定向障碍和颈部强直。实验室检查显示血细胞计数异常、炎症标志物升高及肝功能障碍。脑脊液分析显示淋巴细胞和单核细胞增多以及蛋白水平升高。血培养最终培养出革兰氏阴性球杆菌。血清学检测确诊为神经型布鲁氏菌病。及时的抗生素治疗使临床和实验室指标得到改善。

结论

鉴于神经型布鲁氏菌病非特异性临床表现,本病例强调了在流行地区认识该病的重要性。血培养阳性和血清学检测支持的早期微生物学诊断至关重要。患者对适当抗生素的快速反应强调了及时识别和治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/645f/10928401/5e8540a6efb0/acmi-6-705.v3-g001.jpg

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