Review of 15 Cases of Neurobrucellosis

Abstract

Introduction: Brucellosis is a zoonotic disease remaining endemic worldwide and in Turkey. Central nervous system involvement is a rare complication in brucellosis. This study is an overview of 15 neurobrucellosis cases who were followed in our department as inpatients. Patients and Methods: This study is a retrospective analysis of fi fteen cases of neurobrucellosis in the Infectious Diseases and Clinical Microbiology Department of Inonu University Medical Faculty Hospital between the years 2005-2010. Clinical features, laboratory findings, diagnosis, and treatment strategies were recorded retrospectively. Results: Of the fi fteen patients, 6 were females and 9 were males. Mean age of the patientswas 36.2 years (range, 18-68 years). Mean disease duration before diagnosis was 2 months. The most common symptoms were headache and fever, 66 % and 60 %, respectively. Eight patients (53 %) had visual symptoms, 3 patients (20%) had senso-rineural hearing loss, and 2 patients (13%) had ataxia. Two patients had pancytopenia and four patients had abnormal liver function tests. Two patients did not give informed consent for lumbar puncture (LP). The diagnostic LP performed in all thirteen patients revealed high protein levels and pleocytosis in cerebrospinal fl uid (CSF). Seven patients (53.8 %) had low glucose levels in CSF. Twelve patients (80%) had a serum tube agglutination test value 1/160 or higher. Brucella spp. were isolated from the blood culture of six patients and from the CSF culture of three patients. All patients received antibiotic therapy initially with doxycycline, rifampin, ceftriaxone, and trimethoprim-sulfamethoxazole. None of the patients died, but sequelae resulted in two patients. Conclusion: Patients with unexplained fever, headache, and neurological symptoms should be considered for neurobrucellosis in endemic regions