Overview of neurobrucellosis: a pooled analysis of 187 cases

Brucellosis is the world’s most widespread zoonosis, but also ranks as one of the seven most neglected diseases, according to the World Health Organization. Additionally, it is recognized as the world’s most common laboratory-acquired infection. There are a reported 500,000 incident cases of human brucellosis per year. However, true incidence is estimated to be 5,000,000 to 12,500,000 cases annually. Once diagnosed, focus is directed at treating individual patients with antibiotic regimes, yet overall neglecting the animal reservoir of disease. Countries with the highest incidence of human brucellosis are Syria (1,603.4 cases per 1,000,000 individuals), Mongolia (391.0), and Tajikistan (211.9). Surveillance on animal populations is lacking in many developed and developing countries. According to the World Animal Health Information Database, Mexico had the largest number of reported outbreaks, 5,514 in 2014. Mexico is followed by China (2,138), Greece (1,268), and Brazil (1,142). The majority of these outbreaks is Brucella abortus, the etiologic agent of bovine brucellosis. Brucellosis is an ancient disease that still plagues the world. There are still knowledge gaps and a need for better diagnostics and vaccines to make inroads towards control and eradication.

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“…Pathogenesis of neurobrucellosis is not well characterized. The vast majority of publications relate to case reports and case series [39]. …”

Section: Pathogenesis Clinical Presentation and Risk Factor In Humansmentioning

confidence: 99%

Comparisons of brucellosis between human and veterinary medicine

Hull

Schumaker

2018

Infection Ecology & Epidemiology

146

129

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“…Güven ve ark. nörobruselloz hastalarında en sık 8. kraniyal sinir tutulumu [4], Gül ve ark. da en sık 6. ve 8. kraniyal sinir tutulumu gördükleri-ni belirtmişlerdir [6,8].…”

Section: Erleme Dunclassified

“…dokuz yaşında bir çocukta okulomotor sinir paralizisi bildirmişlerdir [13]. Nörobruselloz seyrinde depresyon, amnezi, psikoz, ajitasyon, kişilik değişikliği ve öfori gibi psikiyatrik tablolar görülebilir [4,14]. Shehata ve ark.…”

Section: Erleme Dunclassified

“…Sıklıkla çiğ süt ve ürünlerinin tüketilmesi veya enfekte hayvanla direkt temas ile bulaşmaktadır [1]. Nörobruselloz merkezi veya periferik sinir sitemini tutabilir ve sıklığı %5,6-37,5 arasında değişmektedir [1,4]. Güven ve ark.…”

Section: Introductionunclassified

“…Beş yüz elli yedi bruselloz hastasının değerlendirildiği bir çalışmada ileri yaş ve uzamış hastalık sü-resinin santral sinir sistemi hasarı gelişmesinde önemli risk faktörü olduğu belirtilmiştir [5]. Nörobruselloz hastaları sıklıkla baş ağrısı, ateş, terleme ve bulantı, kusma yakınma-ları ile kliniklere başvurmaktadır [3,4,6,7]. Bu hastaların fizik bakısında ense sertliği, Kernig gibi meningeal iritasyon bulguları her zaman görülmemekle birlikte kraniyal sinir tutulumu, bilinç bulanıklığı, motor defisit, ekstremitelerde güçsüzlük, dizartri, papil ödemi, konfüzyon ve konvülzi-yon gibi muayene bulgularına rastlanabilir [6,8].…”

Section: Introductionunclassified

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Neurobrucellosis

Tanyel

2017

Ortadogu Tıp Derg

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ÖzBrusellosis ülkemizde endemik olarak görülen bir zoonotik hastalıktır ve sıklıkla pastörize olmamış süt ve süt ürün-lerinin tüketilmesi ile bulaşır. Nörobrusellozis hastalığın ciddi bir komplikasyonudur ve hastalığın herhangi bir safhasında gelişebilir. Nörobrusellozda klinik spektrum santral ve periferal olarak sınıflandırılır. En sık görülen klinik tablolar menenjit, meningoensefalit, myelit ve kraniyal sinir paralizileridir. Nörobruselloz vakalarında psikiyatrik tablolar (depresyon, amnezi, psikoz ve ajitasyon) rapor edilmiştir. Beyin omurilik sıvısının incelemesinde protein konsatrasyonu artmış, glukoz konsantrasyonu azalmış ve başlıca lenfositlerden oluşan orta derecede lökosit artışı mevcuttur. Brusella türlerinin beyin omurilik sıvısından izolasyonu düşük olduğundan nörobruselloz vakalarına en sık serolojik yöntemlerle tanı konulmaktadır. Tedavide doksisiklin, rifampisin, siprofloksasin, seftriakson ve trimetoprim-sülfame-taksazol tercih edilir. Etkili tedavi ile sinir sistemi hasarına bağlı sekel azalır. Anahtar kelimeler: Nörobruselloz, klinik tablolar, tedavi AbstractBrucellosis is an endemic zoonotic disease in our country and it is frequently transmitted to humans by ingestion of unpasteurised milk or milk products. Neurobrucellosis is a serious complication of brucellosis and may develop at any stage of disease. The clinical spectrum of neurobrucellosis classified as central and peripheral. The most frequent clinical presentations are meningitis, meningoencephalitis, myelitis and cranial nerve paralyses. The psychiatric manifestations (depression, amnesia, psychosis and agitation) were reported in neurobrucellosis cases. Examination of the cerebrospinal fluid an elevated protein concentration, a depressed glucose concentration and a moderate leukocytosis compodes mainly of lymphocytes. The isolation rate of Brucella species from cerebrospinal fluid is so low, most of the neurobrucellosis cases were diagnosed by serological methods. Doxycyclie, rifampin, ciprofloxacin, ceftriaxone and trimethoprim-sulfamethoxazole preferred in the treatment of neurobrucellosis. Effective treatment reduce the sequelae caused by nervous system damage.

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Vasculitis and neurobrucellosis: Evaluation of nine cases using radiologic findings

et al. 2018

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BackgroundBrucellosis is an important multisystemic disease with many different clinical symptoms, and its early diagnosis and treatment are possible. Neurobrucellosis (NB) is a rare but serious finding of brucellosis. Brucella can be seen as meningitis and encephalopathy, and it can cause cranial nerve pathologies, vascular syndromes, myopathy, spinal diseases, and psychiatric disorders. In NB, vascular syndromes secondary to inflammation are rarely seen. Here, we present nine young patients with vascular and nonspecific neuropsychiatric findings who had NB as the etiology of stroke.MethodsNine patients who were admitted to our Neurology Clinic between 2012 and 2017 for various reasons in whom brucellosis was found in the etiology were retrospectively studied. The patients' symptoms, physical examination, laboratory and radiographic findings, treatments, and treatment responses are discussed.ResultsOf the nine patients who presented to our clinic in the 4‐year period, five were female. The average age was 49 years. Five patients had small vessel vasculitis, three had great vessel vasculitis, and one had meningoencephalitis and pons abscess. Two patients had granuloma, and one had an aneurysm.ConclusionsWe aimed to present our cases due to the fact that this disease should be kept in mind in the differential diagnosis of patients with stroke and similar neuropsychiatric findings.

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Overview of neurobrucellosis: a pooled analysis of 187 cases

Cited by 153 publications

References 33 publications

Comparisons of brucellosis between human and veterinary medicine

Comparisons of brucellosis between human and veterinary medicine

Neurobrucellosis

Vasculitis and neurobrucellosis: Evaluation of nine cases using radiologic findings

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