The First Clinical Medical College, Lanzhou University, Lanzhou, China.
Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.
Front Cell Infect Microbiol. 2024 May 16;14:1378331. doi: 10.3389/fcimb.2024.1378331. eCollection 2024.
Brucellosis is a zoonotic disease caused by a Gram-negative coccus a facultative intracellular pathogen. Neurobrucellosis has an incidence rate of 3-7% among all patients with brucellosis, while spinal cord involvement is rare and carries a significant mortality risk. This report describes a case of brucellosis myelitis in a 55-year-old male patient who presented with recurrent paralysis, incontinence, and damage to the visual and auditory nerves. The diagnosis of neurobrucellosis involves a serum tube agglutination test, cerebrospinal fluid analysis, a physical examination of the nervous system, and a comprehensive review of the patient's medical history. The presence of brucellosis was confirmed in cerebrospinal fluid using MetaCAP™ sequencing. Treatment with a combination of rifampicin, doxycycline, ceftriaxone sodium, amikacin, compound brain peptide ganglioside, and dexamethasone resulted in significant improvement of the patient's clinical symptoms and a decrease in the brucellosis sequence count in cerebrospinal fluid. For the first time, MetaCAP™ sequencing has been used to treat pathogenic microbial nucleic acids, which could be a valuable tool for early diagnosis and treatment of neurobrucellosis.
布鲁氏菌病是一种由革兰氏阴性球菌引起的人畜共患病，该球菌为兼性细胞内病原体。神经布鲁氏菌病在所有布鲁氏菌病患者中的发病率为 3-7%，而脊髓受累则较为罕见，但死亡率较高。本报告描述了一例 55 岁男性布鲁氏菌病性脊髓炎患者，该患者表现为反复瘫痪、失禁和视觉及听觉神经损伤。神经布鲁氏菌病的诊断需要进行血清试管凝集试验、脑脊液分析、神经系统体格检查以及全面回顾患者的病史。使用 MetaCAP™ 测序在脑脊液中证实了布鲁氏菌病的存在。采用利福平、强力霉素、头孢曲松钠、阿米卡星、复方脑肽神经节苷脂和地塞米松联合治疗，显著改善了患者的临床症状，并降低了脑脊液中布鲁氏菌序列的数量。这是首次使用 MetaCAP™ 测序来治疗致病微生物核酸，这可能是早期诊断和治疗神经布鲁氏菌病的有价值的工具。
