Neurobrucellosis and venous sinus thrombosis: an uncommon association

Lima, Joana Isabel da Silva; Canelas, Cátia; Veiga, Andreia; Carvalho, Dina

doi:10.1590/0037-8682-0288-2015

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…In 1999, Zaidan and Al Tahan published the first case of CVST secondary to neurobrucellosis after the patient presented with signs and symptoms of meningitis [7]. Since then, six more articles have been published describing patients with the same diagnosis [3,4,[8][9][10][11]. CVST caused by neurobrucellosis is a rare presentation with good outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Brucellosis is a multisystemic disease that has broad clinical manifestations. Clinical presentations can range from asymptomatic to severe illness depending on the organ involved [ 3 ]. The main clinical features of brucellosis include undulant fever, fatigue, weakness, myalgia, and arthralgia [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, brucellosis’ neurologic involvement affecting the central and peripheral nervous systems has been reported in 2-7% of cases. The most common neurological manifestations are meningitis, meningoencephalitis, headache, confusion, elevated intracranial pressure, cranial neuropathies, and peripheral neuropathies [ 3 , 4 ]. Cerebral venous sinus thrombosis (CVST) is a rare disease with 1.16 to 2.02 cases per 100,000 globally, a female-to-male ratio of 3:1, and a median age of 37 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Cerebral Venous Sinus Thrombosis Secondary to Neurobrucellosis: A Case Report

Alattas¹,

Khojah²,

Mukhtar³

et al. 2022

Cureus

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Brucellosis is a common infection that rarely causes cerebral venous sinus thrombosis (CVST). In this case, a 23-year-old male presented to the emergency department with status epilepticus. With a past medical history of drinking unpasteurized camel milk, elevated inflammatory markers, and evidence of brucellosis in the serum, the patient was diagnosed with brucellosis. Further investigations revealed left transverse sinus thrombosis extending to the jugular vein. The patient was treated with enoxaparin and a combination of doxycycline, ceftriaxone, and trimethoprim-sulfamethoxazole. This regimen led to rapid and significant clinical improvement in the signs and symptoms of the patient. CVST is a rare complication of neurobrucellosis that might present with signs and symptoms of meningitis. This case report highlights the importance of keeping neurobrucellosis as a possible cause of CVST in patients living in an area endemic to brucellosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cerebral Venous Sinus Thrombosis Secondary to Neurobrucellosis: A Case Report

Alattas¹,

Khojah²,

Mukhtar³

et al. 2022

Cureus

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“…Lima et al reported a 30-year-old woman who was presented with thrombosis of the lateral and sigmoid sinus and ipsilateral internal jugular vein. 10 Brucella spp. was identified in the CSF sample by a polymerase chain reaction.…”

Section: Discussionmentioning

confidence: 99%

“…However, blood cultures are positive in only 16 to 30% of patients with neurobrucellosis, and CSF cultures are positive in less than 50% cases. 10 Brucella microagglutination test is also advised by the Centers for Disease Control and Prevention. CSF Coombs' test agglutination with a cut-off titer 1:8 was found to have a high sensitivity and specificity (0.94 and 0.96, respectively) in neurobrucellosis.…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Neurobrucellosis in a 6-Year-Old Pediatric Patient with Sagittal Sinus Thrombosis

et al. 2020

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Brucellosis is one of the most common zoonosis worldwide. It is still endemic in many regions of the world. A 6-year-old female was admitted to the emergency department (ED) due to a sudden change in consciousness, urinary incontinence, vomiting, and difficulty in walking. Neurological examination demonstrated abducens nerve paralysis, mild-to-moderate motor deficit in hemiparesis in the left arm. Brain magnetic resonance imaging showed a hemorrhagic focus at the right frontal lobe and thrombosis in the superior sagittal sinus of the brain. The diagnosis of neurobrucellosis was confirmed by identifying Brucella spp. in the blood culture on the day 6 of pediatric intensive care unit admission; thus, trimethoprim-sulfamethoxazole and rifampicin, and ceftriaxone were promptly initiated. Despite neuroprotective management and acetazolamide, the patient's neurological problems and high intracranial pressure (ICP) persisted. An external ventricular drainage tube and a Codman ICP monitor were placed to be on the consent vigilance of the patient's neurological condition. The patient's ICP continued to increase despite the current treatment regimen; therefore, a decompressive bitemporal craniectomy was performed. The ICP level of the patient returned to its normal range immediately after the craniectomy. The patient did not have any notable neurologic sequelae at the first-year follow-up. Neurobrucellosis is a rare complication of systemic brucellosis and may present as meningitis, encephalitis, myelitis, radiculitis, and/or neuritis. Herein, we describe a six-year-old girl with brucellosis complicated with cerebral vein thrombosis. This case illustrates the need for close monitoring of patients with unexplained neurological signs or symptoms for brucellosis in endemic areas.

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