Cranial and intracranial brucellosis: Scalp and cranium. Spinal brucellosis: Brucellar spondylitis as a complication of brucellosis.
Peripheral and Cranial nerves: Brucella Polyradiculoneuritis. Therapy of neuro-brucellosis: Medical therapy.
- Clinical, Diagnostic and Therapeutic Features;
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Du kanske gillar. Lifespan David Sinclair Inbunden. Inbunden Engelska, Spara som favorit. Skickas inom vardagar. Skickas inom vardagar specialorder. This book provides an in-depth review of knowledge of neurobrucellosis, which remains common despite significant improvements in preventive measures, neuroradiological techniques, and treatment methods. The chapters are organized into five sections, the first three of which address cranial and intracranial brucellosis, spinal brucellosis, and brucellosis of the peripheral portions of the nervous system.
The fourth section focuses on laboratory studies in neurobrucellosis, and the closing section is devoted to therapy, encompassing both medical approaches and the surgical procedures used to treat the complications associated with brucellosis involving the spine, brain, and peripheral nerves. Gradually the patient presented mild agitation and ataxia. She also reported consumption of rural dairy in about 3 months before admission. In the ward, physical examination showed normal vital signs, but Mini mental status score was significantly decreased.
Moreover, the patient had lower extremities numbness, generalized weakness, and ataxic gait. Other physical examinations were within normal ranges. No neck rigidity was detected. Compared with her previous MRIs, the size and number of the plaques had not changed but the hydrocephaly was a new finding. Considering the abnormal CSF findings and the physical examinations, Vasculitis, Malignancies, Collagen-vascular diseases, Tuberculosis, and fungal meningitis were considered as the possible differential diagnosis, but these conditions were ruled out with the paraclinical evaluations.
Treatment was started with Doxycycline mg twice a day, Rifampin mg daily, and Cefteriaxon 1 gr twice a day. The patient showed a dramatic response to treatment and discharged with an acceptable condition, with doxycycline mg twice a day, rifampin mg daily and Ciprofloxacin mg twice a day. As mentioned in introduction, clinical presentations of neurobrucellosis are nonspecific and subacute. The signs and symptoms of CNS involvement are vague [1,2].
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MRI findings are variable; it may present with normal MRI, or inflammatory changes, and can even show white matter and vascular changes . Brucella Infection triggers the immune mechanism leading to a demyelinating state in CNS. As the disease gets more chronic in a patient, the immune mechanism processes increase. Encephalopathy in neurobrucellosis is always secondary to vascular involvement. Cranial nerve paralyses are seen more frequently during the acute or subacute stages of the disease course associated with diffuse CNS involvement.
The acoustic nerve is the most frequently involved cranial nerve .
Neurobrucellosis is a treatable disease with a favorable outcome. The neurologic sequel may be minimal in these patients. The important prognostic factors are duration of the disease, virulence of the microorganism and early initiation of antibiotic therapy, which makes the early diagnosis important and life-saving. MS is a demylinating disease of CNS which significantly affects young adults especially females. It is considered to develop due to both genetic and environmental factors. The prevalence of MS has a considerable variability worldwide and it seems that its prevalence is increasing in Iran .
Due to several immunomodulating or immunosuppressive treatments in the patients with MS and Chronic suppression of cell-mediated immunity, these patients may be more prone to infections. Therefore, infections must always be considered as a cause of a new sign in these patients. However, any new sign and symptom in MS patients may be due to a new attack of the disease, and the treatment of the attacks is with corticosteroids.
In the patients with subacute infections corticosteroid dramatically worsens the disease and may be fatal. Thus, it is very important to differentiate a new attack and a subacute infection like neurobrucellosis. On the other hand, according to variable MRI findings in the patients with neurobrucellosis there are some reports that presented the patients who were even considered having MS in the primary evaluations but in further investigations neurobrucellosis was diagnosed . Collectively, according to significant increase in the prevalence of MS in Iran and also regarding to this fact that Iran is an endemic area for Brucellosis, these two condition may be seen more frequent than in other parts of the world, so in the patients with MS especially those who are on the immunosuppressive treatments, neurobrucellosis must be considered as a possible differential diagnosis when the patient has a new complaint or clinical presentation.
The prevalence of MS has a considerable variability worldwide and it seems that its prevalence is increasing in Iran  Due to several immunomodulating or immunosuppressive treatments in the patients with MS and Chronic suppression of cell-mediated immunity, these patients may be more prone to infections. Young EJ. Bacterial Infections of Humans.
Isolated intracranial hypertension: a rare presentation of neurobrucellosis. Microbes Infect. A case of neurobrucellosis presenting with isolated intracranial hypertension. J Child Neurol. Neurobrucellosis: clinical and neuroimaging correlation.
Neurobrucellosis - Clinical, Diagnostic and Therapeutic Features | Mehmet Turgut | Springer
Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region. Braz J Infect Dis.
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