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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
06:23

Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis

Published on: May 23, 2021

5.3K

Demyelinating steroid-responsive neurobrucellosis.

Fateen Ata1, Zohaib Yousaf2, Mohammad Khalid Sharif3

  • 1Internal Medicine, Department of Medical Education, Hamad General Hospital,Hamad Medical Corporation, Doha, Qatar.

BMJ Case Reports
|March 11, 2020
PubMed
Summary
This summary is machine-generated.

A young man presented with Brucella infection symptoms, neurological decline, and demyelination. Prompt treatment with pulse steroids led to significant recovery, highlighting their efficacy in severe neurobrucellosis.

Keywords:
disease and health outcomesexposuresinfection (neurology)medical managementmeningitis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Brucellosis is a zoonotic infection with diverse clinical manifestations.
  • Neurological involvement in Brucellosis can be severe and mimic other central nervous system disorders.

Observation:

  • A young male presented with acute systemic symptoms including nausea, vomiting, arthralgia, abdominal pain, fever, and weight loss.
  • He developed gait ataxia, confusion, and disorientation, alongside positive Brucella titres.
  • Cerebrospinal fluid analysis showed lymphocytosis with elevated protein and low glucose, indicative of central nervous system inflammation.

Findings:

  • Despite initial antibiotic treatment, the patient's neurological condition worsened, with MRI revealing diffuse demyelination.
  • Administration of pulse steroids resulted in rapid clinical improvement, normalization of biochemical markers, and resolution of radiological findings.

Implications:

  • This case underscores the potential for severe neurological complications in Brucellosis, including demyelinating lesions.
  • Pulse steroid therapy appears to be a highly effective treatment modality for managing severe neurobrucellosis with demyelination.
  • Early recognition and aggressive management are crucial for favorable outcomes in patients with neurobrucellosis.