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Case Reports
. 2024 Nov;45(11):5441-5448.
doi: 10.1007/s10072-024-07621-6. Epub 2024 Jun 11.

Neurobrucellosis Presenting with Motor Damage or Hearing Loss, and Use of Steroids are Associated with a Higher Risk of Sequelae or Relapse: A Systematic Review of Individual Participant Data

Chiara Fusetti  1 , Francesco Petri  2   3 , Mohammad H Murad  4   5 , Stefania Merli  1 , Riccardo Giorgi  1 , Giuliano Rizzardini  1 , Andrea Gori  1   6   7 , Matteo Passerini  1   6
Affiliations
Case Reports

Neurobrucellosis Presenting with Motor Damage or Hearing Loss, and Use of Steroids are Associated with a Higher Risk of Sequelae or Relapse: A Systematic Review of Individual Participant Data

Chiara Fusetti et al. Neurol Sci. 2024 Nov.

Abstract

Background: Neurobrucellosis presents diverse clinical challenges and risks of long-term complications.

Objective: We aimed to assess the relationship between the duration of antibiotic therapy, clinical factors, and the outcome of neurobrucellosis with a case report combined with a systematic review of the literature.

Methods: We present a case of a 31 years-old man successfully treated at our Institution. We then searched Ovid MEDLINE, Embase and Scopus for articles that encompassed neurobrucellosis cases, duration of treatment, and outcome. The primary outcome was to assess an association between the duration of treatment and the risk of sequelae or relapses. Univariate, multivariate and sensitivity analysis were carried out to define which variables affect​ed​ the clinical outcome. Quality assessment was performed using a dedicated tool.

Results: A total of 123 studies were included, totaling 221 patients. Median duration of treatment was 4 months (IQR 3 - 6), 69% patients recovered without sequelae, 27% had sequelae. Additionally, five patients had a relapse, and 4 patients died. Multivariate analysis found that the duration of treatment, age, and the use of ceftriaxone were not associated with a higher risk of sequelae or relapses. A significant association was found for corticosteroids use (OR 0.39, 95% IC 0.16 - 0.96, p = 0.038), motor impairment (OR 0.29, 95% IC 0.14 - 0.62, p = 0.002), and hearing loss (OR 0.037, 95% IC 0.01 - 0.11, p < 0.001).

Conclusions: This study highlights the variability in clinical presentations and treatment approaches for neurobrucellosis. Patients with factors indicating higher sequelae risk require meticulous follow-up.

Keywords: Brucellosis; Duration of therapy; Hearing loss; Motor impairment; Steroids.

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Conflict of interest statement

CF, FP, SM, RG, MHM and MP declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. GR declare the following financial interests/personal relationships which may be considered as potential competing interests: honoraria for advisory committees, speaking and teaching from AbbVie, Angelini, Gilead, Janssen, GSK, Merck, ViiV, and gran and research support from AbbVie, Gilead, Merck, GSK. AG declare the following financial interests/personal relationships which may be considered as potential competing interests: honoraria from Janssen, ViiV, MSD, BMS, AbbVie, Gilead, Novartis, Pfizer, Astellas, Astrazeneca, Angelini.

Figures

Fig. 1
Fig. 1
– PRISMA 2020 Flow Diagram for systematic reviews including database and registries
See this image and copyright information in PMC

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