Management of neurobrucellosis: an assessment of 11 cases.
OBJECTIVE
The central nervous system involvement of Brucellosis causes a hard to treat infection with multiple sequelae. The aim of this paper is to discuss the course of neurobrucellosis in response to therapy.


METHODS
Patients with neurobrucellosis were evaluated. The diagnosis was established by the isolation of bacteria, abnormal CSF findings and positive serology. Ceftriaxone, rifampicin, doxycycline and trimethoprim sulfamethoxazole were the antibiotic choices for these cases.


RESULTS
We present 11 cases with neurobrucellosis. None of our patients died, albeit one case has a critical situation due to subarachnoid hemorrhage and its' concordant sequelae. Only one of four patients with walking difficulty and two with hearing loss were normalized with therapy. Imaging techniques did not provide any specific contribution regarding the Brucella infection.


CONCLUSIONS
Parenteral ceftriaxone should be used as an initial alternative in the management of neurobrucellosis. Although the therapy should be individualized, the duration of therapy should be a minimum of six months with suitable antibiotics.
Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Hospital, Ankara, Turkey. hcgul@yahoo.com
Hanefi Cem
HC
Gul
Hakan
H
Erdem
Levent
L
Gorenek
Mehmet Fatih
MF
Ozdag
Yasin
Y
Kalpakci
Ismail Yasar
IY
Avci
Bulent Ahmet
BA
Besirbellioglu
Can Polat
CP
Eyigun
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002006:Brucellosis / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy*; D002443:Ceftriaxone / Q000008:administration & dosage; D020806:Central Nervous System Bacterial Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy*; D004318:Doxycycline / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000008:administration & dosage; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage; D014421:Turkey
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D004318:Doxycycline; D012293:Rifampin