Neurobrucellosis in children: Three cases report

Abstract

Neurobrucellosis is an uncommon disease in children. In this paper, we present three cases with neurobrucellosis who were admitted at the same time. Fever and headache were the main complaints in two children; the other child had fever, vomiting and convulsion. Diagnosis was made by isolation of Brucella spp from cerebrospinal (CSF) fluid culture, serum and CSF brucellar agglutination tests were positive in two cases. The third case was a four-month-old infant with breast-milk feeding only. Blood and breast milk cultures were positive for Brucella spp, and serum and CSF brucellar agglutination tests were positive. Furthermore, her mother had clinical findings and serologic criteria consistent with brucellosis. Two cases were treated by ceftriaxone, gentamicin and rifampicin, and one by ceftriaxone, gentamicin and trimethoprim+ sulfamethoxazole. Two cases with cranial nerve involvement were given prednisolone therapy for two weeks. Gentamicin was stopped after three weeks; other drugs were continued for 12 weeks. Two cases completely improved with treatment. The four-month-old infant, who had visual loss, was discharged with anticonvulsant therapy because of focal seizures. No relapse occurred during follow-up period of one year.