Clinical and laboratory characteristics of 5 cases of neurobrucellosis

Abstract:

ObjectiveTo improve clinical and laboratory diagnosis of neurobrucellosis through analysis on clinical data of 5 cases of neurobrucellosis.MethodsClinical and laboratory data of 5 patients with neurobrucellosis in a hospital from January 2015 to June 2017 were analyzed retrospectively.ResultsAll 5 patients had history of cattle and sheep contact or history of eating cattle and sheep products, recurrent fever accompanied by headache was the main symptom. Routine cerebrospinal fluid(CSF) test showed that all patients were positive for pandy test and with leukocytosis (mainly mononuclear cells); biochemical analysis of CSF revealed that protein increased and chloride decreased in all patients, glucose decreased in 3 patients; immunoglobulin IgA and IgG in CSF were several times higher than the normal value; 5 patients were cultured Brucella melitensis, 4 patients showed abnormal brain imaging. Blood routine test showed that white blood cell count(WBC) was slightly higher in 3 patients, liver function (alanine aminotransferase, aspartate aminotransferase, γglutamyltranspeptidase) was normal in 5 patients, highsensitivity Creactive protein(hsCRP) was normal in 4 patients, Brucella antibody tube agglutination test was positive in 1 patient. After 2week treatment with doxycycline combined with rifampin or rifamycin, 5 patients’ body temperature all returned to normal, symptoms of headache and dizziness all relieved; WBC count and protein in CSF all decreased.ConclusionNo characteristic changes in hsCRP and blood routine WBC count are found in the diagnosis of neurobrucellosis. Clinical manifestations of neurobrucellosis are diversity, it is easy to cause missed diagnosis and misdiagnosis, health care workers should improve the understanding of the disease.