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格林-巴利综合征作为神经型布鲁氏菌病的罕见表现:一例罕见病例报告。

GBS as unusual presentation of neurobrucellosis: A rare case report.

作者信息

Soufi Ghazaleh Jamalipour, Hekmatnia Ali, Hekmatnia Farzaneh, Zarei Andrew Parviz, Shafieyoon Shamim, Azizollahi Sara, Riahi Farshad

机构信息

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Radiology, St George's Hospital, London, UK.

出版信息

Radiol Case Rep. 2024 Mar 10;19(6):2125-2129. doi: 10.1016/j.radcr.2024.02.067. eCollection 2024 Jun.

Abstract

Brucellosis is a zoonotic disease caused by small intracellular aerobic Gram-negative bacilli The literature has frequently documented instances of the gastrointestinal, hepatobiliary, and skeletal systems being involved. In 3%-5% of brucellosis patients, neurobrucellosis has been identified. Guillain-Barré syndrome (GBS) is a disorder of the peripheral nervous system. Acute peripheral neuropathy mimicking GBS caused by brucellosis is rarely reported. Our case is of a 34-year-old male presenting with a 3-week history of weakness in the upper limbs. There was a clear history of milk product consumption preceding the onset of symptoms. Examination showed paraesthesia and muscles paralysis. Brucellosis was confirmed via blood test, and GBS was confirmed via imaging and neuroelectrophysiological assessment. The patient was treated with plasma exchange (PLEX) and commenced on rifampicin, doxycycline and gentamicin during their hospitalization. The patient was discharged with a course of rifampicin and doxycycline to complete. In patients with acute paralysis and GBS-like symptoms, Imaging should be done in addition to serological tests for brucellosis.

摘要

布鲁氏菌病是一种由小型需氧细胞内革兰氏阴性杆菌引起的人畜共患病。文献中经常记载有胃肠道、肝胆系统和骨骼系统受累的病例。在3%至5%的布鲁氏菌病患者中,已确诊患有神经型布鲁氏菌病。吉兰-巴雷综合征(GBS)是一种周围神经系统疾病。由布鲁氏菌病引起的类似GBS的急性周围神经病变鲜有报道。我们的病例是一名34岁男性,上肢无力3周。症状出现前有明确的奶制品食用史。检查显示感觉异常和肌肉麻痹。通过血液检测确诊为布鲁氏菌病,通过影像学和神经电生理评估确诊为GBS。患者接受了血浆置换(PLEX)治疗,并在住院期间开始使用利福平、强力霉素和庆大霉素。患者出院时带有利福平和强力霉素疗程以完成治疗。对于有急性麻痹和类似GBS症状的患者,除了进行布鲁氏菌病血清学检测外,还应进行影像学检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a5c/11026928/5a601debba89/gr1.jpg

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