Marzo Sola M E, Calderón Girón C, Ayuso Blanco T, Usón Martín M, Marta Moreno M E, Bestué Cardiel M
Servicio de Neurología, Hospital Miguel Servet, Zaragoza.
Neurologia. 1995 Nov;10(9):375-9.
Thirteen patients with nervous system brucellosis are described. The clinical signs were heterogeneous: meningoencephalitis in 5 cases, meningoradiculitis in another 5, meningomyelitis with cranial neuropathy in 1 and of a vascular nature in 2 others. Neurologic signs appeared during the active phase in 5 patients and later in 8. Diagnosis was based on clinical manifestations, serum and cerebrospinal fluid (CSF) serology, quantitative changes in CSF and favorable response to treatment. Therapy consisted of a combination of 2 or 3 of the following drugs: rifampin, doxycycline, streptomycin and trimethoprim sulfamethoxazole. In spite of favorable evolution, 5 patients suffered sequelae. We suggest that brucellosis be investigated when neurologic deficit ensues with no known etiology, especially in endemic countries.
本文描述了13例神经系统布鲁氏菌病患者。临床症状多种多样:5例为脑膜脑炎,另外5例为脑膜神经根炎,1例为伴有颅神经病变的脊髓脊膜炎,2例为血管性病变。5例患者的神经症状出现在急性期,8例出现在后期。诊断基于临床表现、血清和脑脊液血清学检查、脑脊液的定量变化以及对治疗的良好反应。治疗采用以下2种或3种药物联合使用:利福平、强力霉素、链霉素和复方新诺明。尽管病情进展良好,但仍有5例患者留有后遗症。我们建议,当出现无已知病因的神经功能缺损时,尤其是在布鲁氏菌病流行国家,应考虑布鲁氏菌病的可能。