Neurobrucellosis

ABSTRACT

Purpose: Neurobrucellosis (NB) is a rare complication of brucellosis. NB presents with avariety of clinical manifestations, and the symptoms are always atypical. Our aim was to analyze the demographic characteristics, clinical manifestations, laboratory findings, imaging findings, treatments and outcomes of patients with NB.

Material and Method: We retrospectively reviewed the data from 17 patients with NB hospitalized at the Chinese People's Liberation Army General Hospital between 1 January 2005 and 31 October 2016.

Results: The following symptoms were recorded: 10/17 (59%) patients had fever, and 9/17 (53%) patients had a disorder affecting urination and defecation. Involvement of the cranial nerves was documented in 12/17 (71%) patients. The positivity rates of the tests were as follows: serum standard tube agglutination (STA), 15/17 (88.2%); cerebrospinal fluid STA, 10/17 (59%). The radiologic findings were categorized into four types: normal, white matter changes, vascular insult and inflammatory changes. Patients were treated with different combinations of rifampicin, doxycycline, ceftriaxone sodium and sulphamethoxazole for a total of six months. Two (12%) patients deteriorated, and two (12%) patients were lost to follow-up. The remaining patients (76%) were cured, but sequelae occurred in six patients.

Conclusions: NB should be kept in mind in patients with autonomic dysfunction, especially disorders of urination and defecation. Hearing loss due to vestibulocochlear nerve injury seems to be typical for NB. The high incidence of sequelae may be related to a long disease course and the involvement of the central nervous system. Early detection, diagnosis and treatment could decrease mortality and sequelae.

KEYWORDS:

• Neurobrucellosis
• clinical manifestations
• laboratory findings
• imaging findings
• treatment

Acknowledgments

The authors gratefully acknowledge the Neurology Department and Laboratory Medicine Department of the General Hospital of the People's Liberation Army for assistance.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The source of funding of our study was the General Hospital of the People's Liberation Army [grant number 413EG68N].

Notes on contributors

Na Zheng

Na Zheng is a postgraduate at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army.

Wei Wang

Wei Wang is a postgraduate at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army.

Jia-Tang Zhang

Jia-Tang Zhang is a professor at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army. He is the deputy director the Department of Neurology.

Ya Cao

Ya Cao is a postgraduate at General Hospital of the Peoples' Liberation Army and a physician of Department of Neurology, General Hospital of the Peoples' Liberation Army.

Long Shao

Long Shao is a postgraduate at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army.

Jiao-Jiao Jiang

Jiao-jiao Jiang is a postgraduate at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army.

Xu-Sheng Huang

Xu-Sheng Huang is a professor at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army. He is the deputy director the Department of Neurology.

Cheng-Lin Tian

Cheng-Lin Tian is a professor at General Hospital of the Peoples' Liberation Army and a physician of Department of neurology, General Hospital of the Peoples' Liberation Army. He is the deputy director the Department of Neurology.

Sheng-Yuan Yu

Sheng-Yuan Yu is a professor at General Hospital of the Peoples' Liberation Army and a physician of Department of Neurology, General Hospital of the Peoples' Liberation Army. He is the head of the Department of Neurology.