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840 Neurobrucellosis in Childhood: Four New Cases and a Review of the Literature
  1. HA Ayyash
  1. Pediatrics Department, Islamic Hospital, Amman, Jordan

Abstract

Background and Aims Neurobrucellosis accounts for < 1% of cases of brucellosis in children and has a broad range of clinical manifestations. In this report we describe our experience regarding the epidemiological, clinical, laboratory and therapeutic findings in four children with neurobrucellosis.

Methods During the past nine years we treated four children with neurobrucellosis in the pediatric department, of Islamic Hospital Amman, Jordan.

The diagnosis was based on epidemiological evidence of brucellosis, as well as Serum & cerebrospinal fluid(CSF) serology, quantitative changes in C.S.F and favorable response to treatment. Therapy consisted of combinations of two or three of the following drugs for three months: rifampin, gentamycin, streptomycin and trimethoprim-sulfamethoxazole.

Results The main presenting clinical features included fever, neck stiffness. Neurologic signs appeared during the active phase in two patients and later in ther two patients. The interval from onset of symptoms to diagnosis was from 3 days to 5 months. The mean age of children was 7.2 years, and the male: female ratio 3:1.

Brucella anti bodies were detected in all sera with levels ≥ 320 in two cases and ≥1280 in the other two cases.

Cultures in the blood or C.S.F for brucella were unrevealing in all patients.

Cerebrospinal fluid showed: lymphocytosis (500–2160)µl in all cases, elevated proteins in three cases, decreased glucose in two and a Brucella microaggglutination test titre of of ≥ 1:80 in 2 cases.

Treatment was successful in all patients after 12 months.

Conclusion We suggest that neurobrucellosis should be considered when neurological manifestations ensues with unknown etiology in endemic areas.

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