Abstract
Brusellozis
ülkemizde endemik olarak görülen bir zoonotik hastalıktır ve sıklıkla pastörize
olmamış süt ve süt ürünlerinin tüketilmesi ile bulaşır. Nörobrusellozis
hastalığın ciddi bir komplikasyonudur ve hastalığın herhangi bir safhasında
gelişebilir. Nörobrusellozda klinik spektrum santral ve periferal olarak sınıflandırılır.
En sık görülen klinik tablolar menenjit, meningoensefalit, miyelit ve kraniyal
sinir paralizileridir. Nörobruselloz vakalarında psikiyatrik tablolar
(depresyon, amnezi, psikoz ve ajitasyon) rapor edilmiştir. Beyin omurilik
sıvısının incelemesinde protein konsantrasyonu artmış, glukoz konsantrasyonu
azalmış ve başlıca lenfositlerden oluşan orta derecede lökosit artışı mevcuttur.
Brusella türlerinin beyin omurilik sıvısından izolasyonu düşük olduğundan
nörobruselloz vakalarına en sık serolojik yöntemlerle tanı konulmaktadır. Tedavide
doksisiklin, rifampisin, siprofloksasin, seftriakson ve
trimetoprim-sülfamotoksazol tercih edilir. Etkili tedavi ile sinir sistemi
hasarına bağlı sekel azalır.
Keywords
References
- 1. Buzgan T, Karahocagil MK, Irmak H et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14: 469-78.
- 2. Oueslati I, Berriche A, Ammari L et al. Epidemiological and clinical characteristics of neurobrucellosis case patients in Tunisia. Med Mal Infect 2016;46:123-30.
- 3. Karsen H, Tekin Koruk S, Duygu F, Yapıcı K, Kati M. Review of 17 cases of neurobrucellosis: clinical manifestations, diagnosis, and management. Arch Iran Med 2012;15 (8):491-94.
- 4. Guven T, Ugurlu K, Ergonul O et al. Neurobrucellosis: clinical and diagnostic features. Clin Infect Dis 2013;56 (10):1407-12.
- 5. Zhao S, Cheng Y, Liao Y, Zhang Z, Yin X, Shi S. Treatment efficacy and risk factors of neurobrucellosis. Med Sci Mon 2016; 22:1005-12.
- 6. Gul HC, Erdem H, Bek S. Overview of neurobrucellosis: a pooled analysis of 187 cases. Int J Infect Dis 2009;13:339-43.
- 7. Tarfarosh S, Manzoor M. Neurological manifestaions of brucellosis in an Indian population. Cureus 2016;8(7):1-7.
- 8. Demiroğlu YZ, Turunç T, Karaca S et al. Bruselloza sinir sistemi tutulumu; klinik sınıflama, tedavi ve sonuçlar. Mikrobiyol Bul 2011;45(3):401-10.
- 9. Abdolbagi MH, Rasooli-Nejad M, Jafari S, Hasibi M, Soudbakhsh A. Clinical and laboratory findings in neurobrucellosis: review of 31 cases. Arch Iran Med 2008;11: 21-5.
- 10. Shehata GA, Abdel-Baky L, Rashed H, Elamin H. Neuropsychiatric evaluation of patients with brucellosis. J Neurovir 2010;16:48-55.
- . Shakir RA. Neurobrcellosis. Postgrad Med 1986;62:1077-79.
- 12. Yetkin MA, Bulut C, Erdinç FS, Oral B, Tulek N. Evaluation of the clinical presentations in neurobrucellosis. Int J Infect Dis 2006; 10: 446-52.
- 13. Işıkay S, Olmez A. Neurobrucellosis developing unilateral oculumotor nevre paralysis. Am J Emerg Med 2012; 30: 5-7.
- 14. Kuru AS, Metan G, Aygen B, Sümerkan B. Relaps ile seyreden bir nörobruselloz olgusu ve kısa literatür derlemesi. Erciyes Tıp Derg 2009;31:66-69.
- 15. Eren S, Bayam G, Ergönül Ö et al. Cognitive and emotional changes in neurobrucellosis. J Infect 2006; 53:184-9.
- 16. Erdem H, Ulu-Kilic A, Kilic S et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul Study. Antimicrob Agents Chemother 2011:1523-28.
- 17. Yüce A, Alp-Çavuş S. Türkiye’de bruselloz: genel bakış. Klimik Derg 2006;3:87-97.
- 18. Dağlar DE, Baysan BÖ. İnsanda brusella enfeksiyonlarının tanısında kullanılan tanı yöntemleri. İnönü Üniv Sağlık Bil Derg 2014;3 (2):46-8.
- 19. Bodur H, Erbay a, Akinci E, Colpan A, Cevik MA, Balaban N. Neurobrucellosis in an endemic area of brucellosis. Scand J Infect Dis 2003;35:94-7.
- 20. Balcı M, Kader Ç, Yılmaz N, Uyar M, Erdoğan Y. Endemik bölgelerde bruselloz tanısında serolojik testlerin kombinasyonu. Kafkas J Med Sci 2014;4(1):19-22.
- Araj GF, Lulu AR, Khateeb MI, Saadah MA, Shakir RA. ELISA versus routine tests in the diagnosis of patients with systemic and neurobrucellosis. APMIS 1988;96(2):171-6.
- 22. Araj GF, Lulu AR, Saadah MA, Mousa AM, Strannegard IL, Shakir RA. Rapid diagnosis of central nervous system brucellosis by ELISA. J Neuroimmunol 1986;12:73-82.
- 23. Dizer U, Beker CM, Çicek H, Güner ÖR, Zeren İ, Pahsa A. Bruselloz tanı yöntemlerinin etkinliğinin araştırılması. Uludağ Üniv Tıp Fak Derg 2005;31(2):87-93.
- 24. Al-Sous MW, Bohlega S, Al-Kawi MZ, Alwatban J, Mclean DR. Neurobrucellosis: clinical and neuroimaging correalation. Am J Neuroradiol 2004; 25:395-401.
- 25. Erdem H, Senbayrak S, Meriç K et al. Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study. Infection 2016, DOI 10.1007/s15010-016-0901-3
- 26. Gul HC, Erdem H, Gorenek L et al. Management of neurobrucellosis: an assessment of 11 cases. Inter Med 2008;47:995-1001.
Abstract
Brucellosis
is an endemic zoonotic disease in our country and it is frequently transmitted
to humans by ingestion of unpasteurised milk or milk products. Neurobrucellosis
is a serious complication of brucellosis and may develop at any stage of
disease. The clinical spectrum of neurobrucellosis classified as central and
peripheral. The most frequent clinical presentations are meningitis, meningoencephalitis,
myelitis and cranial nerve paralyses. The psychiatric manifestations
(depression, amnesia, psychosis and agitation) were reported in
neurobrucellosis cases. Examination of the cerebrospinal fluid an elevated
protein concentration, a depressed glucose concentration and a moderate
leukocytosis compodes mainly of lymphocytes. The isolation rate of Brucella species from cerebrospinal
fluid is so low, most of the neurobrucellosis cases were diagnosed by
serological methods. Doxycyclie, rifampin, ciprofloxacin, ceftriaxone and
trimethoprim-sulfamethoxazole preferred
in the treatment of neurobrucellosis. Effective treatment reduce the sequelae
caused by nervous system damage.
References
- 1. Buzgan T, Karahocagil MK, Irmak H et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14: 469-78.
- 2. Oueslati I, Berriche A, Ammari L et al. Epidemiological and clinical characteristics of neurobrucellosis case patients in Tunisia. Med Mal Infect 2016;46:123-30.
- 3. Karsen H, Tekin Koruk S, Duygu F, Yapıcı K, Kati M. Review of 17 cases of neurobrucellosis: clinical manifestations, diagnosis, and management. Arch Iran Med 2012;15 (8):491-94.
- 4. Guven T, Ugurlu K, Ergonul O et al. Neurobrucellosis: clinical and diagnostic features. Clin Infect Dis 2013;56 (10):1407-12.
- 5. Zhao S, Cheng Y, Liao Y, Zhang Z, Yin X, Shi S. Treatment efficacy and risk factors of neurobrucellosis. Med Sci Mon 2016; 22:1005-12.
- 6. Gul HC, Erdem H, Bek S. Overview of neurobrucellosis: a pooled analysis of 187 cases. Int J Infect Dis 2009;13:339-43.
- 7. Tarfarosh S, Manzoor M. Neurological manifestaions of brucellosis in an Indian population. Cureus 2016;8(7):1-7.
- 8. Demiroğlu YZ, Turunç T, Karaca S et al. Bruselloza sinir sistemi tutulumu; klinik sınıflama, tedavi ve sonuçlar. Mikrobiyol Bul 2011;45(3):401-10.
- 9. Abdolbagi MH, Rasooli-Nejad M, Jafari S, Hasibi M, Soudbakhsh A. Clinical and laboratory findings in neurobrucellosis: review of 31 cases. Arch Iran Med 2008;11: 21-5.
- 10. Shehata GA, Abdel-Baky L, Rashed H, Elamin H. Neuropsychiatric evaluation of patients with brucellosis. J Neurovir 2010;16:48-55.
- . Shakir RA. Neurobrcellosis. Postgrad Med 1986;62:1077-79.
- 12. Yetkin MA, Bulut C, Erdinç FS, Oral B, Tulek N. Evaluation of the clinical presentations in neurobrucellosis. Int J Infect Dis 2006; 10: 446-52.
- 13. Işıkay S, Olmez A. Neurobrucellosis developing unilateral oculumotor nevre paralysis. Am J Emerg Med 2012; 30: 5-7.
- 14. Kuru AS, Metan G, Aygen B, Sümerkan B. Relaps ile seyreden bir nörobruselloz olgusu ve kısa literatür derlemesi. Erciyes Tıp Derg 2009;31:66-69.
- 15. Eren S, Bayam G, Ergönül Ö et al. Cognitive and emotional changes in neurobrucellosis. J Infect 2006; 53:184-9.
- 16. Erdem H, Ulu-Kilic A, Kilic S et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul Study. Antimicrob Agents Chemother 2011:1523-28.
- 17. Yüce A, Alp-Çavuş S. Türkiye’de bruselloz: genel bakış. Klimik Derg 2006;3:87-97.
- 18. Dağlar DE, Baysan BÖ. İnsanda brusella enfeksiyonlarının tanısında kullanılan tanı yöntemleri. İnönü Üniv Sağlık Bil Derg 2014;3 (2):46-8.
- 19. Bodur H, Erbay a, Akinci E, Colpan A, Cevik MA, Balaban N. Neurobrucellosis in an endemic area of brucellosis. Scand J Infect Dis 2003;35:94-7.
- 20. Balcı M, Kader Ç, Yılmaz N, Uyar M, Erdoğan Y. Endemik bölgelerde bruselloz tanısında serolojik testlerin kombinasyonu. Kafkas J Med Sci 2014;4(1):19-22.
- Araj GF, Lulu AR, Khateeb MI, Saadah MA, Shakir RA. ELISA versus routine tests in the diagnosis of patients with systemic and neurobrucellosis. APMIS 1988;96(2):171-6.
- 22. Araj GF, Lulu AR, Saadah MA, Mousa AM, Strannegard IL, Shakir RA. Rapid diagnosis of central nervous system brucellosis by ELISA. J Neuroimmunol 1986;12:73-82.
- 23. Dizer U, Beker CM, Çicek H, Güner ÖR, Zeren İ, Pahsa A. Bruselloz tanı yöntemlerinin etkinliğinin araştırılması. Uludağ Üniv Tıp Fak Derg 2005;31(2):87-93.
- 24. Al-Sous MW, Bohlega S, Al-Kawi MZ, Alwatban J, Mclean DR. Neurobrucellosis: clinical and neuroimaging correalation. Am J Neuroradiol 2004; 25:395-401.
- 25. Erdem H, Senbayrak S, Meriç K et al. Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study. Infection 2016, DOI 10.1007/s15010-016-0901-3
- 26. Gul HC, Erdem H, Gorenek L et al. Management of neurobrucellosis: an assessment of 11 cases. Inter Med 2008;47:995-1001.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Review |
| Authors | |
| Publication Date | March 2, 2017 |
| Published in Issue | Year 2017 Volume: 9 Issue: 1 |
e-ISSN: 2548-0251
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