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báo cáo khoa học: " Neurobrucellosis with transient ischemic attack, vasculopathic changes, intracerebral granulomas and basal ganglia infarction: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Neurobrucellosis with transient ischemic attack, vasculopathic changes, intracerebral granulomas and basal ganglia infarction: a case report | Inan et al. Journal of Medical Case Reports 2010 4 340 http www.jmedicalcasereports.eom content 4 1 340 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Neurobrucellosis with transient ischemic attack vasculopathic changes intracerebral granulomas and basal ganglia infarction a case report 1 1 2 1 1 1 Asuman Sengoz Inan Nurgul Ceran Ilknur Erdem Derya O Engin Seniha Senbayrak Seyfi C Ozyurek Pasa Goktas1 Abstract Introduction Central nervous system involvement is a rare but serious manifestation of brucellosis. We present an unusual case of neurobrucellosis with transient ischemic attack intracerebral vasculopathy granulomas seizures and paralysis of sixth and seventh cranial nerves. Case presentation A 17-year-old Caucasian man presented with nausea and vomiting headache double vision and he gave a history of weakness in the left arm speech disturbance and imbalance. Physical examination revealed fever doubtful neck stiffness and left abducens nerve paralysis. An analysis of his cerebrospinal fluid showed a pleocytosis lymphocytes 90 high protein and low glucose levels. He developed generalized tonic-clonic seizures facial paralysis and left hemiparesis. Cranial magnetic resonance imaging demonstrated intracerebral vasculitis basal ganglia infarction and granulomas mimicking the central nervous system involvement of tuberculosis. On the 31st day of his admission neurobrucellosis was diagnosed with immunoglobulin M and immunoglobulin G positivity by standard tube agglutination test and enzyme-linked immunosorbent assay in both serum and cerebrospinal fluid samples the tests had been negative until that day . He was treated successfully with trimethoprim and sulfamethoxazole doxycyline and rifampicin for six months. Conclusions Our patient illustrates the importance of suspecting brucellosis as a cause of meningoencephalitis even if cultures and serological tests are negative at the beginning of the disease. As a result in patients who have a history .