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Liu Y, Gu Y. Case report: A case of abrupt stroke as the first symptom of neurobrucellosis. Front Neurol 2023; 14:1066042. [PMID: 36908632 PMCID: PMC9992872 DOI: 10.3389/fneur.2023.1066042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
Acute cerebral infarction caused by small artery inflammatory disease, which is triggered by neurobrucellosis, is a rare condition that can be easily misdiagnosed. Neurobrucellosis is a rare complication of brucellosis that can present clinically as meningitis, meningoencephalitis, myelitis, neuritis, or psychosis. In this study, we report the case of a patient with neurobrucellosis who was hospitalized in the First People's Hospital of Lianyungang in September 2022; the primary symptom was weakness in the left limb for 14 h. The patient was discharged after receiving symptomatic and anti-Brucella medication.
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Affiliation(s)
- Ying Liu
- Department of Radiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Yan Gu
- Department of Radiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
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Ma C, Li H, Lu S, Li X, Wang S, Wang W. Ocular Lesions in Brucella Infection: A Review of the Literature. Infect Drug Resist 2022; 15:7601-7617. [PMID: 36579126 PMCID: PMC9791996 DOI: 10.2147/idr.s394497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
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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Affiliation(s)
- Chao Ma
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Haoyu Li
- Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China,Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, Hunan, People’s Republic of China
| | - Shuwen Lu
- Department of Ophthalmology, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Xian Li
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, England,School of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, the University of Manchester, Manchester, England
| | - Shuai Wang
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Wenzhan Wang
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China,Correspondence: Wenzhan Wang, Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, Henan, 450052, People’s Republic of China, Tel +86 371-66278091, Email
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Dhar D, Jaipuriar RS, Mondal MS, Shunmugakani SP, Nagarathna S, Kumari P, Mahale R, Mailankody P, Mathuranath PS, Padmanabha H. Pediatric neurobrucellosis: a systematic review with case report. J Trop Pediatr 2022; 69:7008360. [PMID: 36708042 DOI: 10.1093/tropej/fmad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Pediatric neurobrucellosis represents a common anthropozoonosis in endemic areas but only anecdotal reports are available till date. Using appropriate search terms in the database platforms of MEDLINE, SCOPUS and Web of Sciences, we performed a systematic review of all the cases of pediatric neurobrucellosis published in the medical literature till date, in the light of a case report. The protocol was registered under PROSPERO (CRD42022333907). Our search strategy yielded 187 citations of which 51 citations were included. A total of 119 cases were reviewed. Of these cases, eight of them had insufficient data. The most common presentation was meningitis with or without encephalitis (n = 79, 71.2%). A high prevalence of cranial neuropathies (n = 22, 20.7%) was observed in the pediatric population in which abducens palsy was the most common (n = 9, 8.1%). Diagnosis was based on multimodal investigations including standard agglutination test (n = 44, 39.6%), Rose Bengal test (n = 37, 33.3%), blood culture (n = 23, 20.7%), serology (n = 20, 18.0%) and cerebrospinal fluid (CSF) culture (n = 11, 9.9%). Rifampicin-based triple drug regimen was the most commonly employed (83/102, 81.4%). Pediatric neurobrucellosis was associated with greater frequency of sequalae (5.4%), deafness (2.7%) and mortality (2.7%), when compared to that of general population. Neurobrucellosis mimics neuro-tuberculosis in various aspects. The review highlights several unique aspects of this entity in children. A high index of suspicion can ensure prompt diagnosis, timely initiation of management and favorable outcomes.
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Affiliation(s)
- Debjyoti Dhar
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Ravi Shekhar Jaipuriar
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Mahammad Samim Mondal
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Siva Prakash Shunmugakani
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - S Nagarathna
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Pratima Kumari
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Rohan Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - P S Mathuranath
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
| | - Hansashree Padmanabha
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMAHNS), Bangalore, Karnataka 560029, India
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Muacevic A, Adler JR. Cerebral Venous Sinus Thrombosis Secondary to Neurobrucellosis: A Case Report. Cureus 2022; 14:e32677. [PMID: 36545359 PMCID: PMC9761486 DOI: 10.7759/cureus.32677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 12/23/2022] Open
Abstract
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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