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Published on: September 20, 2018
Evaluation of children with neurobrucellosis
1Department of Pediatrics, Yuzuncu Yil University, Van, Turkey.
Insights
Neurobrucellosis, a serious complication of brucellosis, affects the central nervous system. This study highlights diagnosis, treatment, and outcomes in pediatric neurobrucellosis, showing high recovery rates with appropriate management.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroscience
Background:
- Brucellosis is an endemic global disease with a significant rate of central nervous system (CNS) involvement (4-11%).
- Neurobrucellosis presents a diagnostic and therapeutic challenge, particularly in pediatric populations.
- Early recognition and management are crucial to prevent severe neurological sequelae.
Purpose of the Study:
- To describe the clinical experience with diagnosis, treatment, and outcomes of pediatric neurobrucellosis.
- To analyze the presentation, management strategies, and recovery patterns in children with CNS brucellosis.
- To emphasize the importance of considering neurobrucellosis in endemic areas for children with unexplained neurological symptoms.
Main Methods:
- Retrospective review of medical records of 25 pediatric patients diagnosed with neurobrucellosis between 2001 and 2009.
- Inclusion criteria: clinical signs of neurobrucellosis, positive cerebrospinal fluid (CSF) microbiologic/serologic tests, and abnormal CSF findings.
- Analysis of patient demographics, clinical presentation, diagnostic methods, treatment regimens, and patient outcomes.
Main Results:
- The study included 25 pediatric patients (1-15 years, mean 8.8), with a male predominance (15 males, 10 females).
- Common symptoms included headache, fever, and sweating; key findings were fever and meningeal irritation.
- All patients had positive CSF agglutination tests; 84% achieved full recovery, one patient died, and three had sequelae.
Conclusions:
- Neurobrucellosis should be considered in the differential diagnosis of pediatric meningitis or unexplained neurological symptoms in endemic regions.
- Prompt diagnosis and multi-drug treatment regimens are associated with favorable outcomes.
- Clinicians in endemic areas must maintain a high index of suspicion for neurobrucellosis in children presenting with relevant symptoms.
Background:
Brucellosis is an endemic disease in many areas throughout the world. Central nervous system involvement is a serious complication of brucellosis with a ratio of 4-11% of all patients.
Aim:
to describe our experience in diagnosis, treatment, and outcome of 25 pediatric patients with neurobrucellosis.
Patients And Methods:
This study included a review of medical records of patients who were diagnosed with neurobrucellosis between March 2001 and March 2009. Patients who had both clinical findings consistent with neurobrucellosis and positive microbiologic/serologic examinations of CSF with abnormal CSF findings were enrolled in the study.
Results:
The study included 25 patients between 1 and 15 years of age (mean 8.8 years), while 15 were males and 10 were females. Most of the patients (52 %) were in the age group of 5-9 years with male predominance. The distribution of cases showed density in June and February. The most commonly presented complaints were headache, fever and sweating while the most commonly observed findings were fever and meningeal irritation signs. All patients had positive cerebrospinal fluid agglutination test for brucellosis. Four different regimens were used based on ceftriaxone, doxycycline, cotrimoxasole, streptomycin, and rifampicin. One patient died, three patients were discharged with sequel, and the remaining patients (84 %) were discharged with full recovery.
Conclusion:
Clinicians, especially those providing health services in endemic areas like Turkey, should keep in mind that neurobrucellosis can be involved in patients with unexplained symptoms like memory impairment or in patients diagnosed with meningitis (Tab. 5, Fig, 2, Ref. 39).
