Acute brucella meningomyeloencephalo-spondylosis in a teenage male

Abstract

Background: Brucellosis has been known from the time of Hippocrates. In 1885 Sir David Bruce isolated the causative organism from the spleens of soldiers who had died from "Malta disease" (now brucellosis). There are 4 species of brucella pathogenic to humans and each of them has a specific types of animal reservoir: B.arbotus (cattle, buffalo), B.melitensis (goats, sheep, camels), B.suis (pigs), B.canis (Dogs). Humans are infected when they are exposed to body fluids from an infected animal. The symptoms and signs of brucellosis are protean. Diagnosis is usually dependent on clinical features and serology or culture.

Objectives: To describe a case of neurobrucellosis, raise awareness about the existence of the disease in Uganda and Africa in general and share our experiences in its diagnosis and management.

Methods: A male teenager was admitted with symptoms and signs of an acute meningo-encephalitis. He underwent clinical, laboratory and basic radiological evaluation.

Results: The un-incubated brucella titer was significantly reactive(1:160).Oblique-view cervical x-rays showed early osteophyte formation with encroachment on the vertebral foramina on the left hand side. A diagnosis of acute brucella meningomyeloencephalo-spondylosis was made and the patient was successfully treated using conventional therapy for brucellosis (oral doxycycline for 6weeks and IM streptomycin for 2 weeks).

Conclusions: Neurobrucellosis though said to be rare, is a reality in our health units should be considered in the differential diagnosis of neurological and psychiatric illnesses. The good news is that it is curable and is responsive to drugs used for other forms of brucellosis.

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