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病例报告:儿童布鲁氏菌病酷似结核性脑膜炎。

Case Report: Brucellosis Mimicking Tuberculous Meningitis in a Child.

机构信息

Marmara University School of Medicine, Department of Pediatric Infectious Diseases, Istanbul, Turkey.

出版信息

Am J Trop Med Hyg. 2024 Aug 13;111(4):853-855. doi: 10.4269/ajtmh.23-0715. Print 2024 Oct 2.

Abstract

Neurobrucellosis is rare in children, presenting with a variety of clinical manifestations, including meningitis, meningoencephalitis, cranial neuropathies, and intracranial mass-like lesions. We present a case of a 17-year-old girl admitted to the hospital in Istanbul for headache. Lumbar puncture showed elevated intracranial pressure, monocytic pleocytosis, elevated total protein, and hypoglycorrhachia. Brucella melitensis grew from the cerebrospinal fluid. The patient was treated with doxycycline, rifampin, amikacin, and ceftriaxone and showed persistent sensorineural hearing loss. It is essential to consider brucellosis in the differential diagnosis of infectious neurological disease in areas where the disease is endemic. Serologic tests and cultures are needed for diagnosis, and efforts need to be made to identify the infecting organism to the species level to guide zoonotic source control efforts.

摘要

神经布鲁菌病在儿童中较为罕见,可表现出多种临床表现,包括脑膜炎、脑膜脑炎、颅神经病变和颅内肿块样病变。我们报告了一例 17 岁女孩,因头痛入住伊斯坦布尔的医院。腰椎穿刺显示颅内压升高、单核细胞增多症、总蛋白升高和低血糖性。从脑脊液中培养出了羊布鲁菌。该患者接受多西环素、利福平、阿米卡星和头孢曲松治疗,但持续存在感音神经性听力损失。在疾病流行地区,对于感染性神经疾病的鉴别诊断,必须考虑到布鲁菌病。血清学检测和培养对于诊断是必要的,并且需要努力确定感染病原体的种属水平,以指导针对动物源的控制措施。

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