Öz
Brucellosis is a zoonotic infection transmitted from animals to humans mostly by ingestion through infected food products, direct contact with an infected animal. It can involve any organ system and present with a broad spectrum of clinical findings. Central nervous system involvement, so called neurobrucellosis, is rarely seen in pediatric age population. Neurologic manifestations may also show great variability and lead to confusion in diagnosis. Here, we report a case of chronic neurobrucellosis presenting with gradually worsening sensorineural hearing loss and subsequently developed meningitis. A 15 years old girl was diagnosed as neurobrucellosis with the aid of positive serum and CSF agglutination tests, in addition to clinical findings and positive exposure history to unpasteurized dairy products. Clinicians serving in endemic areas should consider brucellosis in differential diagnosis of such atypical clinical presentations to avoid delay in diagnosis and treatment. J Microbiol Infect Dis 2015;5(3): 125-128
Key words: Hearing loss, neurobrucellosis, meningitis.
Anahtar Kelimeler
Kaynakça
- Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005;352:2325-2336.
- Tanir G, Tufekci SB, Tuygun N. Presentation, complications,and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009;51:114-119.
- Lubani MM, Dudin KI, Sharda DC, et al. A multicenter therapeutic
- study of 1100 children with brucellosis. Pediatr Infect Dis J 1989;8:75-78.
- Young EJ. Brucellosis. In: Feigin RD, Cherry MD, Demmler
- GJ, Kaplan SL (eds). Textbook of Pediatric Infectious Diseases
- (Vol. 1, 6th ed). Philadelphia: Saunders; 2009:1678-1683.
- McLean DR, Russell N, Khan MY. Neurobrucellosis. Clinical and therapeutic features. Clin Infect Dis 1992;15:582-590.
- Işıkay S, Yılmaz K, Ölmez A. Neurobrucellosis developing
- unilateral oculomotor nerve paralysis. Am J Emerg Med 2012;30:2085.e5-7.
- Karakurum Goksel B, Yerdelen D, Karatas M, et al. Abducens
- nerve palsy and optic neuritis as initial manifestation in brucellosis.
- Scand J Infect Dis 2006;38:721-725.
- Tonekaboni SH, Karimi A, Armin S, et al. Neurobrucellosis:
- a partially treatable cause of vision loss. Pediatr Neurol 2009;40:401-403.
- Ucmak H, Kokoglu OF, Kirecci E, et al. Hearing loss and accompaning disturbance of Neurobrucellosis cases. Pakistan
- Journal Of Medical Sciences, 2012;28:556-559.
- Guneri EA, Kirkim G, Serbetcioglu BM, et al. Cochlear implantation in neurobrucellosis. Otol Neurotol 2009;30:747-749.
- Cagatay A, Karadeniz A, Ozsut H, et al. Hearing loss in patient
- with neurobrucellosis. South Med J 2006;99:1305-1306.
- Coskun O, Ertem GT, Ergun U, et al. Evaluation of brainstem
- auditory potential in brucellosis patients with and without neurological involvement. Int J Neurosci 2005;5:717-723.
- Yetkin MA, Bulut C, Erdinc FS, et al. Evaluation of the clinical presentations in neurobrucellosis. Int J Infect Dis 2006;10:446-452.
- Mantur BG, Akki AS, Mangalgi SS, et al. Childhood brucellosis:
- a microbiological, epidemiological and clinical study. J Trop Pediatr 2004;50:153–157.
- Araj GF, Lulu AR, Saadah MA, et al. Rapid diagnosis of central
- nervous system brucellosis by ELISA. J Neuroimmunol 1986;12:173-182.
Öz
Brusella, insanlara çoğunlukla enfekte yiyeceklerin yenmesiyle veya enfekte hayvan ile doğrudan temas yoluyla geçen bir zoonozdur. Her organ sistemini tutabilir ve buna bağlı olarak çok çeşitli klinik bulgularla ortaya çıkabilir. Çocukluk çağında merkezi sinir sistemi tutulumu nadirdir. Nörolojik bulgular da çeşitlilik gösterebilir ve bu durum tanıyı güçleştirebilir. Burada giderek ilerleyen çift taraflı sensorinöral işitme kaybı ve sonrasında gelişen menenjit ile başvuran bir nörobruselloz vakası sunuldu. On beş yaşındaki kız çocuğuna, klinik bulguları ve pastörize edilmemiş süt ve süt ürünü alımı öyküsüne ek olarak serum ve BOS aglutinasyon testlerinin pozitif sonuç vermesiyle nörobruselloz tanısı konuldu. Brusellozun endemik olduğu bölgelerde çalışan hekimlerin benzer şekilde atipik belirtilerle başvuran hastalarda nörobrusellozu akılda tutması tanıda gecikmelerin önlenmesi açısından önemlidir
Anahtar Kelimeler
Kaynakça
- Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005;352:2325-2336.
- Tanir G, Tufekci SB, Tuygun N. Presentation, complications,and treatment outcome of brucellosis in Turkish children. Pediatr Int 2009;51:114-119.
- Lubani MM, Dudin KI, Sharda DC, et al. A multicenter therapeutic
- study of 1100 children with brucellosis. Pediatr Infect Dis J 1989;8:75-78.
- Young EJ. Brucellosis. In: Feigin RD, Cherry MD, Demmler
- GJ, Kaplan SL (eds). Textbook of Pediatric Infectious Diseases
- (Vol. 1, 6th ed). Philadelphia: Saunders; 2009:1678-1683.
- McLean DR, Russell N, Khan MY. Neurobrucellosis. Clinical and therapeutic features. Clin Infect Dis 1992;15:582-590.
- Işıkay S, Yılmaz K, Ölmez A. Neurobrucellosis developing
- unilateral oculomotor nerve paralysis. Am J Emerg Med 2012;30:2085.e5-7.
- Karakurum Goksel B, Yerdelen D, Karatas M, et al. Abducens
- nerve palsy and optic neuritis as initial manifestation in brucellosis.
- Scand J Infect Dis 2006;38:721-725.
- Tonekaboni SH, Karimi A, Armin S, et al. Neurobrucellosis:
- a partially treatable cause of vision loss. Pediatr Neurol 2009;40:401-403.
- Ucmak H, Kokoglu OF, Kirecci E, et al. Hearing loss and accompaning disturbance of Neurobrucellosis cases. Pakistan
- Journal Of Medical Sciences, 2012;28:556-559.
- Guneri EA, Kirkim G, Serbetcioglu BM, et al. Cochlear implantation in neurobrucellosis. Otol Neurotol 2009;30:747-749.
- Cagatay A, Karadeniz A, Ozsut H, et al. Hearing loss in patient
- with neurobrucellosis. South Med J 2006;99:1305-1306.
- Coskun O, Ertem GT, Ergun U, et al. Evaluation of brainstem
- auditory potential in brucellosis patients with and without neurological involvement. Int J Neurosci 2005;5:717-723.
- Yetkin MA, Bulut C, Erdinc FS, et al. Evaluation of the clinical presentations in neurobrucellosis. Int J Infect Dis 2006;10:446-452.
- Mantur BG, Akki AS, Mangalgi SS, et al. Childhood brucellosis:
- a microbiological, epidemiological and clinical study. J Trop Pediatr 2004;50:153–157.
- Araj GF, Lulu AR, Saadah MA, et al. Rapid diagnosis of central
- nervous system brucellosis by ELISA. J Neuroimmunol 1986;12:173-182.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 6 Şubat 2016 |
| Yayımlandığı Sayı | Yıl 2015 |