Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman
Journal Title: Oman Medical Journal - Year 2017, Vol 32, Issue 6
Abstract
A ten-year-old boy presented to the hospital with body ache and joint pains for two months and headache, vomiting, and skin rash for three days. He was drowsy and lethargic at admission. Physical examination revealed bilateral papilledema. There were no cranial nerve involvement, neuromotor deficit, or signs of meningeal irritation. Computed tomography and magnetic resonance imaging of the brain did not reveal any evidence of cerebral edema or space occupying lesion. In view of the high endemicity of brucellosis in the area, Brucella agglutination test (BAT) was done at the time of admission and was negative. However, on the eighth day of admission, blood culture showed growth of Brucella melitensis. A repeat BAT at this time was strongly positive with a titer of 1:1 280. The initial one was negative due to prozone phenomenon caused by very high antibody titers. A diagnosis of neurobrucellosis with pseudotumor cerebri was made. He was treated with gentamicin, rifampicin, and septrin along with acetazolamide for raised intracranial pressure. The boy responded well to therapy and made a complete clinical recovery with resolution of papilledema. In areas endemic for brucellosis, a high index of suspicion for neurobrucellosis should be entertained in any child presenting with diverse neurological signs.
Authors and Affiliations
Padam P. Sharma, Mangudi V. Murali, Tahsin Hamdi
Keywords
Related Articles
- EP ID EP259018
- DOI 10.5001/omj.2017.96
- Views 83
- Downloads 0
Immunophenotypic Characteristics of T-Acute Lymphoblastic Leukemia in Omani Patients: A Correlation with Demographic Factors
Objectives: To study and classify the immunophenotypic characteristics of Omani patients diagnosed with T-cell acute lymphoblastic leukemia (T-ALL) and to correlate the results with age and gender as well as biological f...
Important Points in Toxic Epidermal Necrolysis Management
There are several important points that the authors did not highlight which are critical and form the cornerstones in the care of patients with possible TEN. Firstly, the diagnosis, in this case, was delayed for 10 days...
Evaluating the Reliability and Validity of the Maastricht Clinical Teaching Questionnaire in Bahrain
Objectives: The Maastricht Clinical Teaching Questionnaire (MCTQ) was developed to evaluate clinical teachers’ supervisory skills during undergraduate clinical rotations. Evidence exists supporting the reliability and va...
Upper Tract Imaging in Patients with Initial or Terminal Hematuria Suggestive of Bleeding from the Lower Urinary Tract: How Often is the Upper Urinary Tract Responsible for the Hematuria?
Objectives: Visible hematuria (VH) is a common urological complaint. A history of initial or terminal VH in men is indicative of a lower urinary tract (LUT) source. A careful clinical history could limit unnecessary exte...
Hepatitis C Genotypes in Libya: Correlation with Patients’ Characteristics, Level of Viremia, and Degree of Liver Fibrosis
Objectives: Our study sought to determine the distribution of hepatitis C virus (HCV)-genotypes among patients attending two tertiary care hospitals in Benghazi and Tripoli, Libya, and correlate this with patient’s chara...