Acute meningoencephalitis due to Brucella: case report and review of neurobrucellosis in children.
The involvement of the central nervous system (CNS) in brucellosis is rare and has a broad range of presentations. Subacute and chronic meningoencephalitis are described as the most common neurologic manifestations. We report a six-year-old boy with culture-proven neurobrucellosis who presented with an acute picture of meningoencephalitis. Cerebrospinal fluid (CSF) analysis revealed pleocytosis with slight elevation of protein. The agglutination test titer was elevated in serum and Brucella spp. were isolated from both blood and CSF. He was treated with trimethoprim-sulfamethoxazole plus rifampin and streptomycin. His clinical and laboratory features improved with specific antibiotic therapy and no sequela was observed in the short-term follow-up. Due to protean clinical features, unfamiliarity with the disease can delay the diagnosis in children who are not occupationally exposed. In endemic areas, neurobrucellosis should be considered in the evaluation of patients with unexplained neurologic symptoms.
Department of Pediatrics, Bakirköy Maternity and Children's Hospital, Istanbul, Turkey.
Ozden
O
Türel
Kamuran
K
Sanli
Nevin
N
Hatipoğlu
Ciğdem
C
Aydoğmuş
Hüsem
H
Hatipoğlu
Rengin
R
Siraneci
D000208:Acute Disease; D002002:Brucella / Q000302:isolation & purification*; D002006:Brucellosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D002648:Child; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*