Epileptic Seizure: An Atypical Presentation in Brucellosis
,
Abstract
Neurologic involvement occurs in approximately 10% cases of brucellosis and is a serious complication. It manifests with unique and some rare manifestations. We present the first patient with seizures in Brucella meningitis without encephalitis, space-occupying lesion, or vascular involvement. The patient is a 23-year-old man with complaint of seizure. He had generalized weakness for 2 weeks before. In 1st day of admission, he had the second convulsion. Cerebrospinal fluid (CSF) on admission showed lymphocytic pleocytosis and high protein. Brain magnetic resonance imaging and computed tomography scan were normal. Further evaluations resulted a positive Wright, Coombs’ Wright, and 2- mercaptoethanol (2ME) tests. Specific regimen with rifampin, doxycycline, and ceftriaxone in the 1st month then the first two with trimethoprimsulfamethoxazole (TMP-SMX) for 5 months administered. 6 months after completion of treatment in follow-up he has no seizure, systemic or localized symptoms.
Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Saunders; 2015.
Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006; 6(2): 91-9.
Dean AS, Crump L, Greter H, Schelling E, Zinsstag J. Global burden of human brucellosis: a systematic review of disease frequency. PLoS Negl Trop Dis 2012; 6(10): e1865.
Singh K. Laboratory-acquired infections. Clin Infect Dis 2009; 49(1): 142-7.
Faraji F, Didgar F, Talaie-Zanjani A, Mohammadbeigi A. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis. J Neurosci Rural Pract 2013; 4(3): 313-6.
Al Ayed MS. Neurobrucellosis in children, a report of 2 cases. Int J Health Sci (Qassim) 2011; 5(1): 81-4.
Inan AS, Ceran N, Erdem I, Engin DO, Senbayrak S, Ozyurek SC, et al. Neurobrucellosis with transient ischemic attack, vasculopathic changes, intracerebral granulomas and basal ganglia infarction: a case report. J Med Case Rep 2010; 4: 340.
Sohn AH, Probert WS, Glaser CA, Gupta N, Bollen AW, Wong JD, et al. Human neurobrucellosis with intracerebral granuloma caused by a marine mammal Brucella spp. Emerg Infect Dis 2003; 9(4): 485-8.
| Files | ||
| Issue | Vol 1 No 3 (2016): Summer | |
| Section | Case Report(s) | |
| Keywords | ||
| Brucellosis Neurobrucellosis Meningitis Seizure | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
