Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman
A ten-year-old boy presented to the hospital with body ache and joint pains for two months and headache, vomiting, and skin rash for three days. He was drowsy and lethargic at admission. Physical examination revealed bilateral papilledema. There were no cranial nerve involvement, neuromotor deficit,...
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| Format: | Article |
| Language: | English |
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Oman Medical Specialty Board
2017-11-01
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| Series: | Oman Medical Journal |
| Subjects: | |
| Online Access: | http://omjournal.org/articleDetails.aspx?coType=1&aId=2058 |
| _version_ | 1811300254401691648 |
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| author | Padam P. Sharma Mangudi V. Murali Tahsin Hamdi |
| author_facet | Padam P. Sharma Mangudi V. Murali Tahsin Hamdi |
| author_sort | Padam P. Sharma |
| collection | DOAJ |
| description | A ten-year-old boy presented to the hospital with body ache and joint pains for two months and headache, vomiting, and skin rash for three days. He was drowsy and lethargic at admission. Physical examination revealed bilateral papilledema. There were no cranial nerve involvement, neuromotor deficit, or signs of meningeal irritation. Computed tomography and magnetic resonance imaging of the brain did not reveal any evidence of cerebral edema or space occupying lesion. In view of the high endemicity of brucellosis in the area, Brucella agglutination test (BAT) was done at the time of admission and was negative. However, on the eighth day of admission, blood culture showed growth of Brucella melitensis. A repeat BAT at this time was strongly positive with a titer of 1:1 280. The initial one was negative due to prozone phenomenon caused by very high antibody titers. A diagnosis of neurobrucellosis with pseudotumor cerebri was made. He was treated with gentamicin, rifampicin, and septrin along with acetazolamide for raised intracranial pressure. The boy responded well to therapy and made a complete clinical recovery with resolution of papilledema. In areas endemic for brucellosis, a high index of suspicion for neurobrucellosis should be entertained in any child presenting with diverse neurological signs. |
| first_indexed | 2024-04-13T06:48:22Z |
| format | Article |
| id | doaj.art-66575c37f2214586a7bab7438d4b64b6 |
| institution | Directory Open Access Journal |
| issn | 1999-768X 2070-5204 |
| language | English |
| last_indexed | 2024-04-13T06:48:22Z |
| publishDate | 2017-11-01 |
| publisher | Oman Medical Specialty Board |
| record_format | Article |
| series | Oman Medical Journal |
| spelling | doaj.art-66575c37f2214586a7bab7438d4b64b62022-12-22T02:57:29ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042017-11-0132650750910.5001/omj.2017.96Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from OmanPadam P. Sharma0Mangudi V. Murali1Tahsin Hamdi2Department of Pediatrics, Armed Forces Hospital Salalah, Salalah, OmanDepartment of Pediatrics, Armed Forces Hospital Salalah, Salalah, OmanDepartment of Pediatrics, Armed Forces Hospital Salalah, Salalah, OmanA ten-year-old boy presented to the hospital with body ache and joint pains for two months and headache, vomiting, and skin rash for three days. He was drowsy and lethargic at admission. Physical examination revealed bilateral papilledema. There were no cranial nerve involvement, neuromotor deficit, or signs of meningeal irritation. Computed tomography and magnetic resonance imaging of the brain did not reveal any evidence of cerebral edema or space occupying lesion. In view of the high endemicity of brucellosis in the area, Brucella agglutination test (BAT) was done at the time of admission and was negative. However, on the eighth day of admission, blood culture showed growth of Brucella melitensis. A repeat BAT at this time was strongly positive with a titer of 1:1 280. The initial one was negative due to prozone phenomenon caused by very high antibody titers. A diagnosis of neurobrucellosis with pseudotumor cerebri was made. He was treated with gentamicin, rifampicin, and septrin along with acetazolamide for raised intracranial pressure. The boy responded well to therapy and made a complete clinical recovery with resolution of papilledema. In areas endemic for brucellosis, a high index of suspicion for neurobrucellosis should be entertained in any child presenting with diverse neurological signs.http://omjournal.org/articleDetails.aspx?coType=1&aId=2058NeurobrucellosisPseudotumor CerebriProzone Phenomenon |
| spellingShingle | Padam P. Sharma Mangudi V. Murali Tahsin Hamdi Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman Oman Medical Journal Neurobrucellosis Pseudotumor Cerebri Prozone Phenomenon |
| title | Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman |
| title_full | Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman |
| title_fullStr | Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman |
| title_full_unstemmed | Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman |
| title_short | Neurobrucellosis Presenting as Pseudotumor Cerebri: First Report from Oman |
| title_sort | neurobrucellosis presenting as pseudotumor cerebri first report from oman |
| topic | Neurobrucellosis Pseudotumor Cerebri Prozone Phenomenon |
| url | http://omjournal.org/articleDetails.aspx?coType=1&aId=2058 |
| work_keys_str_mv | AT padampsharma neurobrucellosispresentingaspseudotumorcerebrifirstreportfromoman AT mangudivmurali neurobrucellosispresentingaspseudotumorcerebrifirstreportfromoman AT tahsinhamdi neurobrucellosispresentingaspseudotumorcerebrifirstreportfromoman |