Ischemic Stroke as a Rare Manifestation of Neurobrucellosis: A Case Report.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2025-08-25 eCollection Date: 2025-01-01 DOI:10.2147/IDR.S544038

Yang Zhou, Minghui Yun, Xiaocui Han, Chunlei Chen, Chao Wei, Ping Huang, Xinhuan Feng, Jing Chen, Songsong Xie

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Abstract

Background: This article presents a case report of a patient with neurobrucellosis (NB) complicated by ischemic stroke (IS).

Case presentation: A male presented with new-onset left-sided limb weakness lasting three days, along with a 15-month history of intermittent fever and progressive right-sided limb weakness over eight months. A cranial MRI revealed an acute infarction in the left cerebellar vermis. Cerebrospinal fluid (CSF) analysis revealed elevated protein levels and pleocytosis. Next-generation sequencing (NGS) of the CSF detected 1469 Brucella species. Polymerase chain reaction (PCR) testing for the Brucella OMP22 gene was positive in the patient's urine, CSF, and blood samples. Following combination antimicrobial therapy with doxycycline, rifampicin, and trimethoprim-sulfamethoxazole (TMP-SMX), the patient's clinical symptoms progressively improved, and laboratory parameters normalized.

Conclusion: This case underscores the importance of considering NB in the differential diagnosis of patients presenting with unexplained symptoms in brucellosis-endemic regions. Early diagnosis and combined antibiotic therapy are critical to alleviating NB symptoms and improving clinical outcomes.

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缺血性脑卒中作为神经布鲁氏菌病的罕见表现：1例报告。

背景：本文报告一例神经布鲁氏菌病（NB）合并缺血性脑卒中（IS）。病例表现：一名男性，新发左侧肢体无力持续3天，伴有15个月的间歇性发热史，8个多月的进行性右侧肢体无力。颅脑MRI显示左小脑蚓急性梗死。脑脊液（CSF）分析显示蛋白水平升高和多细胞增多。脑脊液的下一代测序（NGS）检测到1469种布鲁氏菌。患者尿液、脑脊液和血液样本的聚合酶链反应（PCR）检测布鲁氏菌OMP22基因呈阳性。经多西环素、利福平、甲氧苄啶-磺胺甲恶唑（TMP-SMX）联合抗菌治疗后，患者临床症状逐渐改善，实验室参数恢复正常。结论：该病例强调了在布鲁氏菌病流行地区对出现不明原因症状的患者进行鉴别诊断时考虑NB的重要性。早期诊断和联合抗生素治疗对于缓解NB症状和改善临床结果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.