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Abstract:
Infection with Brucella melitensis is endemic in Saudi Arabia but involvement of the central nervous system (CNS) is rare. We report on three patients with acute brucella meningitis, all of whom had a history of exposure to a possible source of infection. Diagnosis was confirmed by isolation of Brucella species from blood cultures. Examination of cerebrospinal fluid revealed lymphocytic pleocytosis with a high concentration of protein and low concentration of glucose. The patients were treated by combinations of co-trimoxazole, doxycycline or rifampicin. All responded well without recurrences. A combination of two of the three drugs was effective in treating brucellosis of the CNS when given for a period of 6-8 weeks.
Insights
Brucella melitensis infection rarely affects the central nervous system (CNS). Combination antibiotic therapy for 6-8 weeks effectively treated acute brucella meningitis in three patients.
Area of Science:
- Infectious Diseases
- Neurology
- Public Health
Background:
- Brucella melitensis is endemic in Saudi Arabia.
- Central nervous system (CNS) involvement in Brucella infections is uncommon.
Observation:
- Three patients presented with acute brucella meningitis.
- All patients had a history of potential exposure to Brucella.
- Diagnosis was confirmed via blood cultures isolating Brucella species.
Findings:
- Cerebrospinal fluid analysis showed lymphocytic pleocytosis, high protein, and low glucose.
- Treatment involved combinations of co-trimoxazole, doxycycline, or rifampicin.
- All patients responded well to treatment with no recurrences.
Implications:
- Combination antibiotic therapy (2-3 drugs) for 6-8 weeks is effective for CNS brucellosis.
- Early diagnosis and treatment are crucial for favorable outcomes.
- This highlights the importance of considering Brucella meningitis in endemic areas with neurological symptoms.