The Turkish Journal of Pediatrics
2010 , Vol 52 , Num 4
Acute meningoencephalitis due to Brucella: case report and review of neurobrucellosis in children
Departments of 1Pediatrics, and 2Microbiology, Bakırköy Maternity and Children’s Hospital, İstanbul, Turkey
The involvement of the central nervous system (CNS) in brucellosis is rare and
has a broad range of presentations. Subacute and chronic meningoencephalitis
are described as the most common neurologic manifestations. We report a
six-year-old boy with culture-proven neurobrucellosis who presented with
an acute picture of meningoencephalitis. Cerebrospinal fluid (CSF) analysis
revealed pleocytosis with slight elevation of protein. The agglutination test
titer was elevated in serum and Brucella spp. were isolated from both blood
and CSF. He was treated with trimethoprim-sulfamethoxazole plus rifampin
and streptomycin. His clinical and laboratory features improved with specific
antibiotic therapy and no sequela was observed in the short-term follow-up.
Due to protean clinical features, unfamiliarity with the disease can delay the diagnosis in children who are not occupationally exposed. In endemic areas, neurobrucellosis should be considered in the evaluation of patients with unexplained neurologic symptoms.
Keywords : brucellosis, children, neurobrucellosis, treatment.