Brusellozun Ender Bir Komplikasyonu: Psödotümör Serebri

Year 2011, Volume: 11 Issue: 3, 130 - 132, 01.07.2011

Yasemin Kendir Demirkol Nihal Olgaç Dündar Metehan Özen

https://doi.org/10.5222/j.child.2011.130

Abstract

Bruselloz tüm dünyada yaygın olup, nörobruselloz vakala- rı, merkezi ve periferik sinir sisteminin tutulumuna bağlı olarak çok farklı klinik bulgularla karşımıza gelebilmekte- dir. Vakalar, ender olarak artmış kafaiçi basıncı bulguları ile de başvurabilmektedir. Enfeksiyoz veya postenfeksiyoz durumların psödotümör serebriye neden olduğu bilinmek- tedir. On altı yaşında erkek hasta on gündür olan baş ağrısı ve çift görme yakınması ile başvurdu. Ailesinde pas- törize edilmemiş süt içme öyküsü vardı. Sağ gözde dışa bakış kısıtlılığı izlendi. Yapılan tetkikler sonucu psödotü- mör serebri tanısı konularak asetazolomid başlandı. Bu vakanın, artmış kafaiçi basıncının aktif Brucella infeksiyo- nuna değil, postenfeksiyöz duruma bağlı olduğu kabul edilip tedavi verilmemesi nedeni ile sunulması amaçlan- mıştır

Keywords

Bruselloz, psödotümör serebri, merkezi sinir sistemi

A Rare Complication of Brucellosis: Pseudotumor Cerebri

Abstract

Brucellosis is widespread throughout the world. Cases of neurobrucellosis may present with many different clinical findings based on the involvement of the central and perip- heric nervous systems. The patient can rarely present with signs of increased intracranial hypertension. It is known that infectious and postinfectious cases can cause pseudo- tumor cerebri. A 16-year-old boy was admitted with the complaint of headache and diplopia persisting for ten days. His family reported intake of unpasteurized milk in the past. Limited lateral gaze palsy in the right eye was obser- ved. He was diagnosed as pseudotumor cerebri and given acetazolamide. The aim of this report is to present a patient with increased intracranial pressure presumably caused by postinfectious state rather than active Brucella infection, and mistreated accordingly

Keywords

Brucellosis, pseudotumor cerebri, central nervous system

References

• 1. Friedman DI. Papiledema and pseudotumor cerebri. Ophtalmol Clin North Am 2001;14:129-47. PMid:11370563
• 2. Lahat E, Lehsem M, Barzilai A. Pseudotümör cerebri complicating varicella in a child. Acta Paediatr 1998;87:1310-1. http://dx.doi.org/10.1111/j.1651-2227.1998.tb00959.x
• 3. Akdeniz H, Irmak H, Anlar O, Demiröz AP. Central nervous system brucellosis: Presentation, diagnosis and treatment. J Infect 1998;36:297-301. http://dx.doi.org/10.1016/S0163-4453(98)94279-7
• 4. Raichle ME, Grubb RL Jr, Phelps ME, Gado MH, Caronna JJ. Cerebral hemodynamics and metabolism in pseudotumor cerebri. Ann Neurol 1978;4:104-11. http://dx.doi.org/10.1002/ana.410040203 PMid:707980
• 5. Schoeman JF. Childhood pseudotumor cerebri: clinical and intracranial pressure response to acetozolamide and furosemide treatment in case series. J Child Neurol 1994;9:130-4. http://dx.doi.org/10.1177/088307389400900205 PMid:8006361
• 6. Panagariya A, Sharma B, Mathew V. Pseudotumor like presentation of neurobrucellosis. J Assoc Physicians India 2007;55:301-2. Mid:17694793
• 7. Bashir R, Al-Kawi MZ, Harder EJ, Jinkins J. Nervous system brucellosis: diagnosis and treatment. Neurology 1985;35:1576-81. PMid:3877254
• 8. Vargas JA, Garcio-Merino A, Rodriguez A, Villagra A. Pseudotümör serebri complicating typhoid fever. Eur Neurol 1990;30:345-6. http://dx.doi.org/10.1159/000117370 PMid:2289513
• 9. Morooka T, Hirata M, Fukuya H, Yasumoto S, Ohfu M, Ogata H et al. Pseudotumor cerebri associated with Yersinia pseudotuberculosis infection. Acta Paediatr 1994;83:456-7. http://dx.doi.org/10.1111/j.1651-2227.1994.tb18145.x PMid:8025412
• 10. Gürlek D, Yüksel D, Işık E, Tanır G, Gürer Y. Increased Intracranial Pressure Syndrome Due to Neurobrucellosis: Case Report. Türkiye Klinikleri J Pediatr 2009;18:135-8.