Central nervous system brucellosis: presentation, diagnosis and treatment

J Infect. 1998 May;36(3):297-301. doi: 10.1016/s0163-4453(98)94279-7.

Abstract

Although neurological symptoms in brucellosis are frequent, central nervous system (CNS) involvement is uncommon. Five patients with neurobrucellosis are presented. Three patients presented with meningoencephalitis, one with polyradiculoneuritis and one with myelitis and an eighth nerve palsy. All patients had lymphocytic pleocytosis, low glucose and elevated levels of protein in the cerebrospinal fluid (CSF). Gamma-globulin and IgG values in the CSF were also increased. Results of agglutination tests for Brucella in serum and CSF were positive for all patients, although titres were less in the CSF. Brucella melitensis was cultured from two patients. Treatment included concurrent administration of three of the following drugs: doxycycline, rifampicin, streptomycin, co-trimoxazole, ceftriaxone or ciprofloxacin. The three patients with meningoencephalitis fully recovered; the other two patients were left with minor disability.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Brucella melitensis
  • Brucellosis / diagnosis*
  • Brucellosis / drug therapy
  • Brucellosis / pathology
  • Central Nervous System Infections / diagnosis
  • Central Nervous System Infections / drug therapy
  • Central Nervous System Infections / microbiology*
  • Central Nervous System Infections / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Turkey

Substances

  • Anti-Bacterial Agents