Zhu Yuda, Sun Meixuan, Chen Baiyu, Liu Xiaoting, Yang Guanglu, Li Xiaohua
From the Department of Pediatrics, Inner Mongolia Medical University Hospital, Hohhot city, Inner Mongolia Autonomous Region.
Pediatr Infect Dis J. 2025 Jun 2;44(9):e329-32. doi: 10.1097/INF.0000000000004845.
To explore the clinical characteristics of neurobrucellosis in children and the diagnostic value of metagenomics next-generation sequencing (mNGS) of cerebrospinal fluid and traditional microbial detection methods.
Three patients in the pediatrics department from April 2022 to October 2023 were diagnosed with brucellosis, and 5 mL of cerebrospinal fluid was taken and sent for routine biochemical, bacterial Gram-stained smear, antacid-stained smear, ink staining, bacterial culture and second-generation sequencing of the microgeneration of the cerebrospinal fluid, respectively (Beijing AJiAn Genetics Medical Laboratory). Cranial magnetic resonance imaging, blood culture and blood Brucella antibody test were also performed to summarize the clinical features and pathogenic analysis.
The chief presentations were fever, headache, vomiting, somnolence and positive signs of meningeal irritation in all patients. Case 3: persistent hemiparesis of the left limb and cerebral infarction. Brucella was detected by cerebrospinal fluid mNGS in all cases, with sequence numbers of 5252, 162 and 59 Brucella and relative abundances of 80.26%, 6.14% and 1.06%, respectively. Cerebrospinal fluid cultures were negative, and blood cultures were positive in case 3.
The clinical characteristics of neurobrucellosis in children are variable, and meningoencephalitis is common. Traditional microbiological tests are difficult to detect Brucella, whereas cerebrospinal fluid mNGS can provide a precise diagnosis.
探讨儿童神经型布鲁氏菌病的临床特征以及脑脊液宏基因组下一代测序（mNGS）和传统微生物检测方法的诊断价值。
选取2022年4月至2023年10月在儿科确诊为布鲁氏菌病的3例患者，分别采集5 mL脑脊液送检脑脊液常规生化、细菌革兰氏染色涂片、抗酸染色涂片、墨汁染色、细菌培养及脑脊液微生物二代测序（北京爱基安医学检验实验室）。同时进行头颅磁共振成像、血培养及血布鲁氏菌抗体检测，总结临床特征并进行病原学分析。
所有患者主要表现为发热、头痛、呕吐、嗜睡及脑膜刺激征阳性。病例3出现左侧肢体持续性偏瘫及脑梗死。所有病例脑脊液mNGS均检测到布鲁氏菌，序列数分别为5252、162和59，相对丰度分别为80.26%、6.14%和1.06%。脑脊液培养均为阴性，病例3血培养阳性。
儿童神经型布鲁氏菌病临床特征多样，脑膜脑炎常见。传统微生物检测方法难以检测到布鲁氏菌，而脑脊液mNGS可提供准确诊断。
