Unilateral Optic Neuritis as a Presentation of Neurobrucellosis

Marques, R. S.; Martins, Cristina Araújo; Machado, Inês; Monteiro, José Paulo; Campos, Nuno; Calhau, Paulo

doi:10.4081/pr.2011.e11

Cited by 7 publications

(4 citation statements)

References 10 publications

(4 reference statements)

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“…In the event of optic nerve oedema due to Brucella infection, one of the possible pathogeneses is vasculitis, a characteristic manifestation of brucellosis. 23 The prognosis for patients with optic nerve papilloedema secondary to vasculitis is relatively poor, and most will eventually develop optic nerve atrophy. 25 In addition to optic nerve injury due to vasculitis, increased intracranial pressure due to Brucella infection can also lead to optic nerve papillary oedema and elevated cerebrospinal fluid (CSF) pressure.…”

Section: Resultsmentioning

confidence: 99%

Ocular Lesions in Brucella Infection: A Review of the Literature

et al. 2022

IDR

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Ocular lesions due to Brucella infection are uncommon and easily overlooked in clinical management, but must be differentiated from non-infectious eye diseases and treated promptly to protect the patient's vision. We reviewed the relevant literature and identified 47 patients with ocular complications of Brucella infection. Among them, 28 showed ocular neuropathy, 15 presented with uveitis, and four patients displayed other ocular symptoms. Ocular symptoms accompanying Brucella infection require prompt diagnosis and treatment. The main methods of diagnosis are intraocular fluid tests and blood tests. Early diagnosis and treatment with suitable antibiotics are central to protecting the patient's vision. Notably, in terms of mechanism of injury, Brucella infection is chronic and cannot be eliminated by phagocytes, and can cause damage to the eye by inducing autoimmune reactions, antigen-antibody complex production, release of endogenous and exogenous toxins, and bacterial production of septic thrombi in the tissues. In this review, we summarize the ocular symptoms, diagnosis, treatment and prognosis of Brucella infection, and discuss the mechanisms of Brucella in ocular lesions, providing a reference for the diagnosis and treatment of Brucella ocular lesions.

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Section: Resultsmentioning

confidence: 99%

Ocular Lesions in Brucella Infection: A Review of the Literature

et al. 2022

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“…Four patients had isolated optic neuritis. 11,12,14,15 Two patients also had other cranial nerve involvement along with the optic nerve. 10,13 It has been denoted that antibiotic and prednisolone therapy was given to the patients in these reports.…”

Section: Discussionmentioning

confidence: 99%

A rare pediatric case of neurobrucellosis with bilateral optic neuritis

Havalı

Çağan

2020

Turk J Pediatr

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Background. The estimated incidence of central nervous system involvement in brucellosis ranges between 0 and 17.8%. Optic neuritis is infrequently seen in the clinical presentation of neurobrucellosis. Only six cases of neurobrucellosis manifesting with optic neuritis have been previously reported in the literature during childhood. Moreover, four of these were isolated optic neuritis. Case. An 11-year-old boy presented with the complaint of bilateral visual loss which was more prominent in the left eye than the right. He was diagnosed with brucellosis two months prior. His fundus examination revealed mild papilledema of the right eye and remarkable papilledema of the left eye. Brucella agglutination titer of serum was 1/640. Cerebrospinal fluid (CSF) cultures were negative, but polymerase chain reaction (PCR) examination in CSF was positive for Brucella melitensis. Antibiotic and pulse methylprednisolone treatments were administered. The visual acuity returned incompletely within the 12-month follow-up period. Conclusion. Isolated optic neuritis is a rare manifestation of neurobrucellosis in children.

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“…Neurobrucellosis manifesting as vasculitis, as seen in our patient, is an unusual but well-described manifestation of brucellosis [ 8 , 12 ]. 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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Unilateral Optic Neuritis as a Presentation of Neurobrucellosis

Cited by 7 publications

References 10 publications

Ocular Lesions in Brucella Infection: A Review of the Literature

Ocular Lesions in Brucella Infection: A Review of the Literature

A rare pediatric case of neurobrucellosis with bilateral optic neuritis

An Interesting Case of Neurobrucellosis Mimicking Neuropsychiatric Lupus

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