六例神经型布鲁菌病患者临床特点分析

目的探讨神经型布鲁菌病的临床特点,以提高对该病的诊治能力。方法对运城市中心医院感染科自2014年1月至2019年12月收治的6例确诊为神经型布鲁菌病的患者,收集并分析其流行病学史、临床表现、辅助检查结果、治疗经过、预后等临床资料。结果6例患者均为男性,2例患者有明确的流行病学史,1例患者合并睾丸炎,1例患者伴脑血管病变相关影像学异常;3例患者脑脊液培养出马耳他布鲁菌,1例患者血培养出马耳他布鲁菌;2例患者脑脊液虎红平板凝集试验阳性,脑脊液二代测序结果为布鲁菌属核酸序列;予抗生素治疗后6例患者均预后良好。结论神经型布鲁菌病的临床表现多样,脑脊液培养、脑脊液布鲁菌凝集试验、脑脊液二代测序等多种方法联合应用可以提高神经型布鲁菌病的诊断率。

Clinical features of six patients with neurobrucellosis

Objective To explore the clinical characteristics of neurobrucellosis to improve the diagnoses and treatments of this disease.Methods Six inpatients diagnosed with neurobrucellosis in our hospital from Junuary 2014 to December 2019 were chosen,and their epidemiological features,clinical manifestations,laboratory tests,treatments,and prognoses were analyzed.Results Six patients were male,2 had epidemiological history,one was with orchitis,one was with imaging abnormalities related to cerebral small vessel diseases;3 patients had brucella malta in the cerebrospinal fluid and one had brucella malta in the blood;cerebrospinal fluid(CSF)rose bengal plate agglutination test was positive in 2 patients,and the next-generation sequencing results of CSF showed that they were brucella nucleic acid sequences.All 6 patients had good prognosis after antibiotic therapy.Conclusion The clinical manifestations of neurological brucellosis are diverse;the combined application of cerebrospinal fluid culture,cerebrospinal fluid brucella agglutination test,and next-generation sequencing is of great value in the diagnosis of neurobrucellosis.