The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 2
An Unusual Case of Neurobrucellosis Presenting as Demyelination Disorder
1Divisions of Pediatric Neurology, and 2Pediatric Infectious Diseases, Department of Pediatrics and 3Department of Radiology,
Ankara University Faculty of Medicine, Ankara, Turkey. E-mail: bektasomer@gmail.com
Brucellosis is a public health problem in most countries in the Mediterranean.
Involvement of the central nervous system is seen in 4-13% of patients with
brucellosis. A 13-year-old girl was admitted because of gait disturbance,
diplopia, and dizziness. Her complaints began about 1.5 years ago. The second
symptomatic episode repeated about three months ago and the third two
months ago. In total, attacks repeated 3 times over 1.5 years. The magnetic
resonance imaging (MRI) and the clinical features mimicked multiple sclerosis.
The patient was given pulse steroid treatments. After steroid treatment, her
gait disturbance and diplopia improved over the short term. Following positive
developments, her symptoms recurred. The tests were repeated; the MRI
showed increasingly high signal abnormalities, and Brucella melitensis was
grown in cerebrospinal fluid. The patient was started on an oral combination
of rifampin, doxycycline, and ciprofloxacin. MRI findings improved markedly
after nine months of treatment. Although neurobrucellosis is associated rarely
with demyelination in adults, this finding has not been reported previously
in children or adolescents. Additionally, this case is the first in terms of
involvement of the corpus callosum in neurobrucellosis. In this article, we
present an unusual case of neurobrucellosis.
Keywords :
neurobrucellosis, demyelination, multiple sclerosis, corpus callosum
involvement, neurologic sequelae, white matter.