| Abstrakt: |
Introduction: Brucellosis is an endemic disease with a high mortality rate still seen in Mediterranean countries such as our country. Neurobrucellosis, on the other hand, is a clinical condition with a high mortality, which occurs when the disease affects the central nervous system. We aimed to emphasize that it is a diagnosis that should be kept in mind by presenting a rare case of neurobrucellosis that we followed in our intensive care unit (ICU). Case: Sixty-eight years old female (hypertension, retired teacher), has a history of eating cheese. She was hospitalized in the ward with a preliminary diagnosis of neurobrucellosis due to joint pain, insomnia, fatigue for 20 days and syncope two days ago. Rose bengal test was negative, Brucella agglutination 1/160 positive, Brucella IgG/IgM negative, CRP: 71 and ESR: 69. Brain CT showed a 42x23 mm hypodense edema area in the left frontal area. The patient was admitted to our intensive care unit due to cardiac arrest in the infection ward. On mechanical ventilation, hypointense areas at the pons level in the contrast-enhanced brain MRI of the patient, who was hemodynamically stable, were found to be compatible with neurobrucellosis. During this period, doxycycline and rifampicin treatments were continued. Choreiform movements were observed. Upon detection of generalized slow wave activity and intermittent suppression activity in EEG, levatiracetam was started. Tracheostomy and PEG were performed for the patient who was in the prolonged intensive care unit. In the control brain MRI, it was determined that the ischemic area triggered by the infective process regressed (Figure 1). The patient died on the 99th day of hospitalization due to septic shock. Discussion: Neurobrucellosis is one of the rare and serious complications in regions where brucellosis is endemic, such as our country. It should be kept in mind in areas such as meningitis that are difficult to diagnose [ABSTRACT FROM AUTHOR] |
