A23yearoldwomanfro
2021-12-11 来源：不详 浏览次数：次A23-year-oldwomanfromaruralareawithlow-gradefeverfor4months,nowwithacuteweaknessinbothlowerlimbsandinabilitytopassurine
Whatisyourdiagnosis?
TheanswerisNeurobrucellosis
AdditionalClinicalHistory:Hadapetcow;oftendrankunpasteurizedmilkBackground:NeurobrucellosisisanendemiczoonoticinfectioncausedbybacterialgenusBrucella.Itistransmittedtohumansbyinfectedanimals(sheep,cattle,goats,pigs,anddogs)urine,milk,andotherfluids.TheendemicareasofbrucellosisincludetheMediterraneanregion,LatinAmerica,westernAsia,andpartsofAfrica,accordingtotheCDC.
ClinicalPresentation:Thesymptomsofneurobrucellosismayincludesymptomslikeheadache,fever,ormuscleorjointpain,alongwithneurologicsymptomssuchasconfusion,meningoencephalitis,myelitis,peripheralandcranialneuropathies,andpsychiatricmanifestations.Placeofresidenceordietary,travel,oroccupationalhistorysuggestsariskfortheinfection.
KeyDiagnosticFeatures:SignandsymptomsofneurobrucellosisPositivebloodcultureIsolationofBrucellaspeciesfromcerebrospinalfluidand/orpresenceofanti-BrucellaantibodiesinCSFPresenceoflymphocytosis,increasedprotein,anddecreasedglucoselevelsintheCSFFindingsonMRIorCT:MRI,hyperintenseperiventricularandwhitematterlesionsonT2WIandFLAIR
DifferentialDiagnosis:DemyelinatingdisordersViralencephalomyelitisGranulomatousencephalomyelitis(ie,tuberculosis,fungalinfection,andsarcoidosis)
Conclusion:Neurobrucellosisisatreatablediseasewithafavorableout
