| 杨静，王起，朱慧，赵静*，王培福*.3例神经型布氏杆菌病的临床特点并文献复习[J].神经损伤功能重建,2021,16(7):378-381 |
| 3例神经型布氏杆菌病的临床特点并文献复习 |
| Clinical Features of Neurobrucellosis: A Report of 3 Cases and Literature Review |
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| DOI： |
| 中文关键词: 布氏杆菌病 中枢神经系统感染 神经型布氏杆菌病 临床特点 治疗 预后 |
| 英文关键词: brucellosis central nervous system bacterial infections neurobrucellosis clinical feature treatment prognosis |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨神经型布氏杆菌病（NB）的临床特点。方法：回顾性分析我院3例确诊为NB患者的临床
资料，同时结合文献总结该病的主要临床特点。结果：3例患者均为男性，有明确的牛羊接触史。病例1以
发热、听力下降起病，逐渐出现肢体力弱表现。病例2出现缓慢进展性双下肢无力，病程后期出现腰背痛。
病例3以卒中起病，病程中出现关节痛及脊髓损害表现。3例患者脑脊液常规均白细胞轻度升高，蛋白升
高，葡萄糖及氯化物降低，1例布氏杆菌培养阳性。3例患者布氏杆菌凝集试验均阳性。2例患者MRI出现
异常信号。2例患者规律治疗后病情改善，1例患者复发。搜索既往报道的NB患者310例，以外周神经受
累多见，中枢神经系统损害以慢性脑膜炎最常见。结论：NB临床较少见，对于有疫区居住及牛、羊接触史，
症状出现反复发热，合并神经系统损害体征的患者，应考虑本病，及时进行病原学检查明确诊断，早期联合
抗生素治疗预后良好。 |
| 英文摘要: |
| To investigate clinical features of neurobrucellosis (NB). Methods: The clinical data
of 3 NB patients were retrospectively analyzed and combined with relevant literature to further analyze clinical
feature of the disease. Results: The 3 NB cases were all male patients with a definite epidemiological history
of contacting with cattle and sheep. Case 1 presented with fever and hearing loss upon onset then gradual limb
weakness. Case 2 displayed progressive weakness of both lower limbs and lower back pain at the late stage of
disease. Case 3 presented with stroke at onset then gradually developed joint pain and spinal cord damage.
Routine cerebrospinal fluid (CSF) examination of all 3 cases showed a mild increase of white blood cells
(WBCs), increase of protein, and decrease of glucose and chloride. The CSF culture was positive for brucella in
1 case, and all 3 cases were positive for the brucella agglutination test. Two patients displayed abnormal signals
on MRI. Two patients improved after regular treatment, and 1 patient relapsed. Data of 310 NB cases were
collected from MEDLINE. Peripheral nerve involvement was frequently reported, and chronic meningitis was
the most common impairment of the central nervous system. Conclusion: NB is a rare disease. Patients living
in endemic areas, who contacted cattle or sheep, and who present with undulant fever and related impaired
neurological signs should be considered for NB. Etiological examination should be performed as soon as
possible. Early treatment with antibiotics is effective and yields a favorable prognosis. |
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