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Neuro-brucellosis in children

M S Bessisso1, M F Elsaid, S S Elshazli

  • 1Pediatrics Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. Fax. 00 974 392 204. E-mail. mbessisso@hotmail.com.

Neurosciences (Riyadh, Saudi Arabia)
|November 5, 2013
PubMed

Insights

Neurobrucellosis, a rare nervous system infection in children caused by Brucella, requires a high index of suspicion for diagnosis. Successful treatment involves a combination of antibiotics.

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.

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