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Published on: August 5, 2016
Brucella Shunt Infection as a Rare Presentation of Neurobrucellosis
Fatemeh Mehrabian1, Zahra Abdi Layaee2, Zahra Ahmadinejad3
1Internal Medicine Resident, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:
Brucellosis, as a systemic infection with potential to involving virtually all organ systems, is an endemic zoonosis in Iran. This is the history of a 17-year-old boy with a ventriculoperitoneal (VP) shunt who presented with prolonged fever, constipation, and abdominal pain. Laboratory studies, including cerebrospinal fluid (CSF) and blood tests, revealed a VP shunt infection with Brucella spp. We treated the patient with rifampicin, trimethoprim-sulfamethoxazole (cotrimoxazole), and ceftriaxone. Also, the shunt was temporarily replaced with an extraventricular drain until the CSF culture was sterile and a new permanent VP shunt could be inserted. We report this case to underline the diagnostic possibility of brucellosis in every case of protracted fever of unknown origin (FUO), irrespective of accompanying signs and symptoms.
Insights
Brucellosis, a zoonotic infection, can affect any organ system. This case highlights the importance of considering brucellosis in prolonged fever of unknown origin, especially in patients with medical devices like ventriculoperitoneal shunts.
Area of Science:
- Infectious Diseases
- Neurology
- Public Health
Background:
- Brucellosis is an endemic zoonotic infection in Iran, capable of affecting multiple organ systems.
- Ventriculoperitoneal (VP) shunts are used to treat hydrocephalus but can be susceptible to infection.
- Protracted fever of unknown origin (FUO) presents a diagnostic challenge.
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