Seronegative neurobrucellosis—do we need new neurobrucellosis criteria?

Papadopoulos, Vassilis E; Patas, Kostas; Tountopoulou, Argyro; Velonakis, Georgios; Boufidou, Fotini; Chatzipanagiotou, Stylianos; Vassilopoulou, Sophia

doi:10.1016/j.ijid.2021.08.038

Cited by 4 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diagnosis of neurobrucellosis among laboratory-confirmed cases of brucellosis is confirmed by isolation of brucella from CSF and/or positive anti-Brucella antibodies in CSF [ 14 ]. However, diagnosis can be challenging, since serological testing can sometimes yield negative results [ 15 ] and the sensitivity of culture-based methods varies depending on laboratory techniques and quantity of bacteria in the CSF [ 16 ]. Other diagnostic methods such as CSF metagenomic next-generation sequencing (mNGS) and 16 s rRNA sequencing technique are also used in diagnosing neurobrucellosis [ 17 ]; however, they are rarely available in the endemic areas.…”

Section: Introductionmentioning

confidence: 99%

Neurobrucellosis: report of 54 cases

et al. 2022

View full text Add to dashboard Cite

Background Brucellosis is among the most widespread zoonotic diseases worldwide. Although rare, nervous system involvement due to Brucella infection is a major diagnostic challenge in endemic regions. Patients and methods This study was a cross-sectional investigation of hospitalized adults with neurobrucellosis from March 2007 to February 2017. We described the clinical characteristics, radiographical and laboratory features, and clinical outcomes of patients with neurobrucellosis. Results Fifty-four patients with neurobrucellosis were included. The median age was 35 (interquartile range, 25–50) years, and 32 (59%) cases were male. Thirty-four (63%) patients were stockmen or shepherds. The most common clinical manifestations were fever in 49 (91%) cases, headache in 47 (87%), decreased consciousness in 12 (22%), and seizures in 6 (11%). Meningeal signs were detected in 36 (67%) cases. Brucella species were isolated in five cases from blood or cerebrospinal fluid (CSF). The median of CSF leukocytes was 75 per µL, CSF protein 83 mg/dL, and CSF glucose 39 mg/dL. Only two cases had severe hypoglycorrhachia and one CSF protein ≥ 500 mg/dL. No patient died during hospitalization. Conclusions The symptoms of neurobrucellosis could be mild and nonspecific and the classic triad of meningitis is uncommon. Mild CSF pleocytosis of fewer than 50 leukocytes per microliter of CSF was common but severe hyperproteinorrhachia and severe hypoglycorrhachia were rare in neurobrucellosis. Differentiation between neurobrucellosis and systemic brucellosis is important, because more prolonged treatment is indicated for neurobrucellosis, and it could be associated with a broad spectrum of complications that require close follow-up.

show abstract

Section: Introductionmentioning

confidence: 99%

Neurobrucellosis: report of 54 cases

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Diagnosis of brucellosis can be challenging due to its nonspecific symptoms and wide presentations. In addition, serological testing can sometimes yield negative results [ 13 ]. Neurobrucellosis is diagnosed when any one of the following criteria is met.…”

Section: Clinical Discussionmentioning

confidence: 99%

Neurobrucellosis presenting with the features of meningoencephalitis: A case report from Nepal

Acharya¹,

Regmi²,

Manandhar

et al. 2022

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

“…The positive culture of Brucella in blood or cerebrospinal fluid serves as the “gold standard” for diagnosing NB ( Shakir et al., 1987 ). NB cerebrospinal fluid typically exhibits elevated protein levels, increased white blood cell count (predominantly lymphocytes), and decreased levels of glucose and chloride ( Zheng et al., 2018 ), and serological tests have a positive rate of only 28% ( Guven et al., 2013 ), cannot differentiate between current and previous infections, and consequently tend to produce false positive results ( Papadopoulos et al., 2021 ), thereby limiting their broad utilization. Relying solely on laboratory results is insufficient for an accurate diagnosis.…”

Section: Discussmentioning

confidence: 99%

“…NB is a rare but potentially fatal complication of brucellosis. It is essential to identify an efficient diagnostic test that can facilitate doctors to diagnose and treat patients with negative serum or cerebrospinal fluid to prevent severe outcomes ( Papadopoulos et al., 2021 ).…”

Section: Discussmentioning

confidence: 99%

Brucellosis infection complicated with myelitis: a case report and literature review

Ma,

Wang,

et al. 2024

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Brucellosis is a zoonotic disease caused by a Gram-negative coccus a facultative intracellular pathogen. Neurobrucellosis has an incidence rate of 3-7% among all patients with brucellosis, while spinal cord involvement is rare and carries a significant mortality risk. This report describes a case of brucellosis myelitis in a 55-year-old male patient who presented with recurrent paralysis, incontinence, and damage to the visual and auditory nerves. The diagnosis of neurobrucellosis involves a serum tube agglutination test, cerebrospinal fluid analysis, a physical examination of the nervous system, and a comprehensive review of the patient’s medical history. The presence of brucellosis was confirmed in cerebrospinal fluid using MetaCAP™ sequencing. Treatment with a combination of rifampicin, doxycycline, ceftriaxone sodium, amikacin, compound brain peptide ganglioside, and dexamethasone resulted in significant improvement of the patient’s clinical symptoms and a decrease in the brucellosis sequence count in cerebrospinal fluid. For the first time, MetaCAP™ sequencing has been used to treat pathogenic microbial nucleic acids, which could be a valuable tool for early diagnosis and treatment of neurobrucellosis.

show abstract

Seronegative neurobrucellosis—do we need new neurobrucellosis criteria?

Cited by 4 publications

References 14 publications

Neurobrucellosis: report of 54 cases

Neurobrucellosis: report of 54 cases

Neurobrucellosis presenting with the features of meningoencephalitis: A case report from Nepal

Brucellosis infection complicated with myelitis: a case report and literature review

Contact Info

Product

Resources

About