Evaluation of clinical, diagnostic features and therapeutic outcome of neurobrucellosis: a case series and review of literature

Patra, Sudipta; Eshwara, Vandana Kalwaje; Pai, Anand; Varma, Muralidhar; Mukhopadhyay, Chiranjay

doi:10.1080/00207454.2020.1860969

Cited by 16 publications

(15 citation statements)

References 61 publications

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“…According to some foreign scholars, fever with headache is considered the most common clinical manifestation[6], while meningitis and encephalitis are frequently observed as the main clinical features. Additionally, cerebral nerve involvement, polyneuropathy, and paraplegia are noted as the primary complications in NB patients [5,11]. In our group of patients, fever and headache were the prevailing symptoms, accounting for approximately 3/4 of the total cases.…”

Section: Discussionmentioning

confidence: 58%

“…Differentiating NB from tuberculous meningitis should be given high priority in clinical practice since their CSF biochemical and cytological examinations are similar [11,23]. The positivity rates of CSF and blood culture in NB patients are generally low, being 18.4% and 21.7%, respectively [5]. The low positive CSF culture rate could be due to a low bacterial load in the patient's CSF or the prior use of antibiotics before CSF culture [15,27].…”

Section: Discussionmentioning

confidence: 99%

“…NB exhibits severe and diverse clinical manifestations, including meningitis, encephalitis, meningoencephalitis, radiculitis, myelitis, subarachnoid hemorrhage, peripheral and cranial neuropathies, and psychiatric abnormalities [5]. This complexity makes it challenging to differentiate NB from other neurological disorders [6].…”

Section: Introductionmentioning

confidence: 99%

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Characterization of 38 cases of Neurobrucellosis

Qi,

Niu,

Ren

et al. 2024

Preprint

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Aim：In this study, we thoroughly examine and discuss the clinical features, laboratory findings, treatment, and recovery of 38 neurobrucellosis cases. Additionally, we provide insights into the most recent research advances in the field of neurobrucellosis. Materials and methods：In this study, we collected general data, clinical characteristics, ancillary tests, and treatment plans of 38 cases of neurobrucellosis diagnosed and treated at the General Hospital of Ningxia Medical University from March 2012 to December 2022. Results：Among the 38 cases, 25 were male, and 23 had a clear history of cattle and sheep exposure. The most common clinical manifestations were fever (81.58%) and headache (76.32%). Brucella agglutination test was positive in 37 patients, and 37 patients showed increased protein in the cerebrospinal fluid. All 38 patients had a complete blood routine, with 11 cases showing abnormal white blood cell counts. Among the 29 patients who underwent cranial magnetic resonance imaging, 12 showed abnormalities. There were no in-hospital deaths among the patients. Conclusions：Neurobrucellosis exhibits diverse clinical manifestations and can be difficult to differentiate from tuberculous meningitis. Routine tests such as complete blood routine and cranial magnetic resonance imaging have limited diagnostic value for neurobrucellosis and are prone to clinical misdiagnosis and underdiagnosis. Patients with a history of contact with cattle and sheep in nearby grazing areas and presenting with symptoms such as fever and headache should undergo laboratory tests such as Brucella agglutination test or cerebrospinal fluid culture to establish an early and accurate diagnosis. Prompt initiation of treatment with doxycycline, rifampin, and ceftriaxone sodium triple therapy against Brucellosis is crucial in areas close to pastoral regions with potential cattle and sheep exposure.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Characterization of 38 cases of Neurobrucellosis

Qi,

Niu,

Ren

et al. 2024

Preprint

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“…The antibiotics selection should regard its permeability to CSF. Therefore, the third-generation cephalosporins (such as ceftriaxone and cefotaxime), rifampicin, and co-trimoxazole have a good penetration in CNS and should be combined [44]. Ceftriaxone (4 g/day) for the first 4–6 weeks, in addition to rifampin at 15 mg/kg/day (600–900 mg) and doxycycline (100 mg twice a day), for at least 12 weeks, are considered the first-line therapy.…”

Section: Treatmentmentioning

confidence: 99%

Neurobrucellosis

Soares

Silva

Lima

2023

Current Opinion in Infectious Diseases

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Purpose of reviewBrucellosis is one of the most common zoonosis worldwide, affecting 500 000 people, annually. Neurobrucellosis incidence is approximately 4%, and it is almost always heterogeneous. As there are no typical clinical features, its diagnosis is frequently misdiagnosing by other infections.Recent findingsNeurobrucellosis picture includes meningitis, meningoencephalitis, encephalitis, cranial neuropathies, intracranial hypertension, sinus thrombosis, hemorrhages radiculitis, peripheral neuropathy, myelitis, and psychiatric manifestations. The diagnosis should be based on symptoms and signs suggestive of neurobrucellosis, not explained by other neurological disease, cerebrospinal fluid analysis, a positive Brucella serology or culture, and a response to specific antibiotics, with a significant improvement of cerebrospinal fluid parameters.SummaryNeurobrucellosis can be insidious, and despite its global distribution, it is still unrecognized and frequently goes unreported. The understanding of the current epidemiology is necessary for eradication of the disease in humans, as well as the disease control in animals and prevention based on occupational hygiene and food hygiene.

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“…2 The treatment for non-pregnant adults includes doxycycline 100 mg, twice daily, Rifampicin 600 mg, once daily, and thirdgeneration Cephalosporins 2.0 g, IV twice-daily for the first 4-6 weeks and the duration should last for at least 3-6 months or until normalization of CSF. 2,10 Patient perspective. The patient shared that this is her first time being introduced to this disease.…”

Section: Therapeutic Interventionmentioning

confidence: 99%

Unusual presentation of neurobrucellosis in Jeddah, Kingdom of Saudi Arabia

Kanjo

Ahmed

Alnahari

2021

NSJ

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A 35-year-old female without any history of medical or psychiatric illness. One month prior to presenting to our clinic, she had intermittent headaches, night sweats, and muscle pain that went unnoticed by her. A week later, the patient developed agitation and behavioral changes. The patient was admitted through emergency room (ER) to the psychiatry unit for 3 days. During a detailed interview in the Neurology Clinic 10 days post discharge, she described the previously mentioned symptoms. Her cerebrospinal fluid analysis revealed leukocytosis, with normal protein and glucose, and positive brucella titers in blood. She received antibiotics for neurobrucellosis with frequent follow ups. Repeated spinal tap was reported normal. Her symptoms gradually improved. Neuropsychiatric manifestations are an unusual presentation of brucellosis. This case emphasizes the importance of considering an organic cause, such as neurobrucellosis, as a differential diagnosis in patients with new onset of unexplained neuropsychiatric symptoms in endemic countries like Kingdom of Saudi Arabia.

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Evaluation of clinical, diagnostic features and therapeutic outcome of neurobrucellosis: a case series and review of literature

Cited by 16 publications

References 61 publications

Characterization of 38 cases of Neurobrucellosis

Characterization of 38 cases of Neurobrucellosis

Neurobrucellosis

Unusual presentation of neurobrucellosis in Jeddah, Kingdom of Saudi Arabia

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