Neuro-brucellosis in children

Abstract

Brucellosis is an infection caused by gram negative cocobacilli (Brucellae). Presentation is usually non-specific and diagnosis depends on high index of suspicion. Nervous system involvement in children is rare as only 47 cases were reported until 1998. We are reporting two patients with neurobrucellosis. The first case was an 8-year-old boy who presented with papillodeoma, and neck stiffness of one month duration. Cerebrospinal fluid pressure was 360mm/water, protein 0.63gm/dl, and cerebrospinal fluid sugar/serum sugar 0.2/4.7mmol. Brucella titer was high in serum and cerebrospinal fluid. The second case was a 3-year-old girl with congenital hydrocephalus, with history of fever, loss of weight, and abdominal cyst around the distal end of ventriculo-peritoneal shunt tube. Brucella mellitenesis was isolated from cerebrospinal fluid and blood. Both cases were treated successfully by 3 antibiotics for 8-12 week.