Clinical analysis of 27 neurobrucellosis patients

Abstract

Objective To analyze the clinical characteristics and prognosis of neurobrucellosis (NB). Methods Twenty-seven cases of NB patients who received treatment in Disease Prevention and Control Center of Inner Mongolia Autonomous Region and Inner Mongolia Medical University Hospital from January to December in 2016 were collected. The clinical data of these patients were recorded and systematically analyzed. Results Twenty-four cases (88.89%) had a history of exposure to cattle and sheep. Twenty-four cases (88.89%) were admitted with fever, 18(66.67%) cases with sweat, 16 cases(59.26%) with headache, 14 cases (51.85%) with neurological symptoms of meningitis and meningoencephalitis, 4 cases (14.81% ) with auditory nerve damage and 3 cases (11.11%) with spinal cord damage. Elevated white blood cells were found in 2 cases (7.41%), elevated serum C-reactive protein in 3 cases (11.11%), elevated procalcitonin in 2 cases (7.41%) and elevated erythrocyte sedimentation rate in 15 cases (55.56%). All the 27 patients underwent lumbar puncture and the cerebrospinal fluid test results were abnormal, of which increased protein levels in 17 cases (62.96%), increased mononuclear cell ratio 14 cases (51.85%), increased pressure in 14 cases (51.85%), and reduced chloride levels in 14 cases (51.85%), and reduced glucose levels in 6 cases (22.22%). Positive cerebrospinal fluid culture (CSF) was found in 1 case (3.70%). There were 8 cases (29.63%) with white matter damage, 5 cases (18.52%) with meningeal enhancement, 3 cases (11.11%) with spinal cord lesions, 2 cases (7.41%) with cerebral edema and 2 cases (7.41%) with brain abscess. There were 10 cases (37.04%) with sensory nerve damage in the extremities, 4 cases (14.81%) with auditory nerve damage and 2 cases (7.41%) with motor nerve damage. All patients were treated with regular anti-Berg′s disease for 6 weeks and were followed up for 1 year (every 3 months) after the treatment. Nineteen patients (70.37%) were cured, 7 patients (25.93%) developed sequelae and 1(3.70%) patient died. Conclusions The analysis suggests that NB have a variety of clinical characteristics. CSF examination, imaging examination and neuro electrophysiology detection have contribution to the diagnosis of the NB. Key words: Neurobrucellosis; Clinical features; Cerebrospinal fluid characteristics; Neuroimaging; Neuro electrophysiology