Neuropediatrics
DOI: 10.1055/s-0040-1715482
Short Communication

A Rare Presentation of Neurobrucellosis in a 6-Year-Old Pediatric Patient with Sagittal Sinus Thrombosis

Ozden Turel
1  Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
,
Fatouma Khalif Abdillah
2  Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
,
3  Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
,
Selcuk Uzuner
4  Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
,
Burcu Bursal Duramaz
1  Department of Pediatric Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
,
Tolga Turan Dundar
5  Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey
,
Mehmet Hakan Seyithanoglu
5  Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey
,
Osman Yesilbas
4  Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
,
Nurettin Onur Kutlu
4  Department of Pediatric Critical Care Medicine, Bezmialem Vakif University, Istanbul, Turkey
› Author Affiliations
Funding None.

Abstract

Brucellosis is one of the most common zoonosis worldwide. It is still endemic in many regions of the world. A 6-year-old female was admitted to the emergency department (ED) due to a sudden change in consciousness, urinary incontinence, vomiting, and difficulty in walking. Neurological examination demonstrated abducens nerve paralysis, mild-to-moderate motor deficit in hemiparesis in the left arm. Brain magnetic resonance imaging showed a hemorrhagic focus at the right frontal lobe and thrombosis in the superior sagittal sinus of the brain. The diagnosis of neurobrucellosis was confirmed by identifying Brucella spp. in the blood culture on the day 6 of pediatric intensive care unit admission; thus, trimethoprim-sulfamethoxazole and rifampicin, and ceftriaxone were promptly initiated. Despite neuroprotective management and acetazolamide, the patient's neurological problems and high intracranial pressure (ICP) persisted. An external ventricular drainage tube and a Codman ICP monitor were placed to be on the consent vigilance of the patient's neurological condition. The patient's ICP continued to increase despite the current treatment regimen; therefore, a decompressive bitemporal craniectomy was performed. The ICP level of the patient returned to its normal range immediately after the craniectomy. The patient did not have any notable neurologic sequelae at the first-year follow-up. Neurobrucellosis is a rare complication of systemic brucellosis and may present as meningitis, encephalitis, myelitis, radiculitis, and/or neuritis. Herein, we describe a six-year-old girl with brucellosis complicated with cerebral vein thrombosis. This case illustrates the need for close monitoring of patients with unexplained neurological signs or symptoms for brucellosis in endemic areas.

Authors' Contributions

All authors participated in creating content for the manuscript, editing, and provided final approval for submission. No undisclosed authors contributed to the manuscript.


Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors. Institutional Review Board approval was not required for this case report.




Publication History

Received: 05 February 2020

Accepted: 22 April 2020

Publication Date:
05 October 2020 (online)

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