Neuro-brucellosis in children.

Area of Science:

• Infectious Diseases
• Pediatric Neurology
• Microbiology

Background:

• Brucellosis is a bacterial infection caused by gram-negative cocobacilli (Brucellae).
• Nervous system involvement (neurobrucellosis) in children is rare, with limited reported cases.
• Clinical presentation of brucellosis is often non-specific, complicating early diagnosis.

Purpose of the Study:

• To report two pediatric cases of neurobrucellosis.
• To highlight the diagnostic challenges and successful management of neurobrucellosis in children.

Main Methods:

• Case report of two pediatric patients presenting with symptoms suggestive of neurobrucellosis.
• Diagnostic procedures included cerebrospinal fluid analysis (pressure, protein, glucose) and serological testing for Brucella titers.
• Microbiological cultures were performed on cerebrospinal fluid and blood samples.

Main Results:

• The first patient, an 8-year-old boy, presented with papilledema and neck stiffness, exhibiting high Brucella titers in serum and cerebrospinal fluid.
• The second patient, a 3-year-old girl with congenital hydrocephalus, had Brucella melitensis isolated from cerebrospinal fluid and blood.
• Both patients showed successful treatment outcomes.

Conclusions:

• Neurobrucellosis in children, though rare, should be considered in the differential diagnosis of neurological symptoms.
• Prompt diagnosis supported by cerebrospinal fluid analysis and serology, followed by appropriate antibiotic therapy, leads to successful outcomes.
• Combination antibiotic therapy for 8-12 weeks is effective in treating pediatric neurobrucellosis.