Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study

Erdem, Hakan; Şenbayrak, Seniha; Meriç, Kaan; Batırel, Ayşe; Karahocagil, Mustafa Kasım; Hasbun, Rodrigo; Şengöz, Gönül; Karsen, Hasan; Kaya, Selçuk; İnal, Ayşe Seza; Pekok, Abdullah Umut; Çelen, Mustafa Kemal; Deniz, Seçil; Ulug, Mehmet; Demırdal, Tuna; Namıduru, Mustafa; Tekin, Recep; Güven, Tümer; Parlak, Emine; Bölükçü, Sibel; Avcı, Meltem; Sıpahi, Oğuz Reşat; Öztürk-Engin, Derya; Yaşar, Kadriye Kart; Pehlivanoğlu, Filiz; Yılmaz, Emel; Ates-Guler, Selma; Mutlu-Yilmaz, Esmeray; Tosun, Selma; Sırmatel, Fatma; Şahin-Horasan, Elif; Akbulut, Ayhan; Öztoprak, Nefise; Çağ, Yasemin; Kadanalı, Ayten; Turgut, Hüseyin; Baran, Ali İrfan; Gül, Hanefi Cem; Sünnetçioğlu, Mahmut; Haykir-Solay, Asli; Denk, Affan; İnan, Asuman; Ayaz, Celal; Ülçay, Asım; Köse, Şükran; Ağalar, Canan; Elaldı, Nazif

doi:10.1007/s15010-016-0901-3

Cited by 29 publications

(22 citation statements)

References 35 publications

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“…Although imaging with MRI and CT can be normal, but could be fairly suggestive, with high signal white matter lesions seen in cases of meningoencephalitis, enhancing lesions, which can be periventricular, are a reported [29,30). Meningeal enhancement is seen in cases of meningitis and ventriculitis (Fig.…”

Section: Imagingmentioning

confidence: 99%

Brucellosis

Shakir

2021

Journal of the Neurological Sciences

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Brucellosis is a common Zoonosis affecting half a million people annually. The most common mode of infection is by consuming unpasteurized milk or milk products. The general manifestations are those of fever with generalized symptoms. The nervous system is affected in 4-7% of cases. The manifestations are protean and include meningo-encephalitis as well as peripheral nervous system involvement. The diagnosis relies on culture, which is cumbersome and can be falsely negative. Agglutination tests for the various species of the organism are the mainstay for diagnosis. Treatment is for 3-6 months with combination therapy including Doxycycline, Rifampicin and ceftriaxone. The main issue is prevention and better animal husbandry.

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Section: Imagingmentioning

confidence: 99%

Brucellosis

Shakir

2021

Journal of the Neurological Sciences

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“…While studies of patients with neurobrucellosis have shown the most commonly affected cranial nerve is VIII [ 1 , 10 ], and involvement of optic nerve secondary to vasculitis has been documented [ 10 , 15 , 18 ]. There are theories that these vasculitic changes may be related to an immune-mediated reaction in the CNS due to Brucella infection [ 17 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

An Interesting Case of Neurobrucellosis Mimicking Neuropsychiatric Lupus

Bains

Dahhan

Belzowski

et al. 2018

Case Reports in Rheumatology

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This case describes a patient presenting with acute onset papilledema, subacute strokes resulting in upper extremity weakness and numbness, arthritis, maculopapular rash, depressed C4 and CH50, and a high titer anti-double-stranded DNA antibody. The patient was given the diagnosis of probable systemic lupus erythematosus, which was supported by the Systemic Lupus International Collaborating Clinics (SLICC) criteria. He was aggressively treated for neuropsychiatric lupus (NPSLE) with pulse dose steroids and a dose of intravenous cyclophosphamide. Blood cultures drawn on admission later grew out 2/4 bottles of Gram-variable bacteria, speciated as Brucella melitensis by PCR. Serum Brucella serologies were also positive. On further evaluation, the patient noted a history of eating unpasteurized cheese in Mexico. Given these additional findings, the patient's presentation was most consistent with a diagnosis of neurobrucellosis. Steroids were tapered off, no further doses of cyclophosphamide were given, and a prolonged course of intravenous and oral antibiotic therapy was administered, resulting in complete resolution of the patient's presenting symptoms.

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“…The radiological diagnosis of neurobrucellosis is based on the existence of a CNS images not explained by any other neurological disease [14] . Only 45 % of patients affected with neurobrucellosis present radiological abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…Only 45 % of patients affected with neurobrucellosis present radiological abnormalities. The radiological findings can be grouped in 4 categories: (i) Inflammatory lesions: cerebral abscess, granulomas and arachnoiditis, leptomeningeal lesions, basal meningeal or cranial nerves impairments, (ii) White matter impairment with or without demyelinising lesions, (ii) Vascular lesions with chronic ischemic cerebral disease, (iv) Hydrocephalus, cerebral oedema [14] .…”

Section: Discussionmentioning

confidence: 99%

Brucellosis: A cause of meningitis not to neglect

Lemnouer

Frikh

Maleb

et al. 2017

IDCases

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Brucellosis is the most frequent bacteria zoonosis in the world, with more than half a million new cases each year [1]. It is also the most significant zoonos in the edge of the Mediterranean Sea [2]. This zoonosis is capable of affecting humans and cause polymorphic clinical manifestations. In Morocco, the southern regions are the main affected areas [3].We are reporting the observation of a 17-year-old male patient, who presented a febrile meningeal syndrome for 9 months without sensitivo-motor deficit. Tuberculosis is frequently evoked in such clinical presentations because Morocco is an endemic country, brucellosis is therefore often forgotten. The results of lumbar puncture, magnetic resonance imaging (MRI) and especially serology aided to conclude to a neuro-brucellosis. The outcome was favourable with antibiotic therapy.

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Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study

Abstract: In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.

Cited by 29 publications

References 35 publications

Brucellosis

Brucellosis

An Interesting Case of Neurobrucellosis Mimicking Neuropsychiatric Lupus

Brucellosis: A cause of meningitis not to neglect

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