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Subacute meningitis caused by Brucella: a diagnostic challenge.
1Department of Paediatrics, Haifa City Medical Centre (Rothschild), Technion, Israel.
European Journal of Pediatrics
|November 1, 1988
Summary
Subacute meningitis caused by Brucella mellitensis can be difficult to treat. This case highlights successful antibiotic therapy and the slow recovery of cerebrospinal fluid (CSF) findings.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Brucella mellitensis is a zoonotic pathogen that can cause various clinical manifestations, including neurobrucellosis.
- Meningitis is a serious complication of Brucella infection, often requiring prolonged treatment.
Observation:
- A case of subacute meningitis caused by Brucella mellitensis is presented.
- The patient's meningitis was refractory to an initial antibiotic regimen.
- Diagnosis was confirmed by elevated Brucella antibody titers in serum and cerebrospinal fluid (CSF), alongside positive blood and bone marrow cultures.
Findings:
- Treatment with tetracycline, trimethoprim-sulfamethoxazole, and streptomycin led to a dramatic clinical improvement.
- Cerebrospinal fluid (CSF) abnormalities normalized gradually over a 6-month period post-treatment.
Implications:
- This case underscores the importance of considering Brucella infection in meningitis, especially in endemic areas.
- Effective antibiotic combinations can achieve clinical cure, but prolonged monitoring of CSF parameters is necessary.
- Highlights the challenges in managing refractory neurobrucellosis and the slow resolution of neurological sequelae.