4例神经型布氏杆菌病临床特点及文献复习

Clinical features of neurobrucellosis：a report of 4 cases and literature review

目的：探讨神经型布氏杆菌病的临床特点。方法回顾性分析我院自2013年1月-2014年2月收治的4例神经型布氏杆菌病患者的流行病学资料、临床表现、病原学检查、腰穿检查和影像学表现，并结合文献分析神经型布氏杆菌病的主要临床特点。结果神经型布氏杆菌病以脑实质、脊髓、脑脊髓膜和神经根受累为主，脑脊液检查多呈炎性改变，影像学检查在部分患者能够发现脑、脊髓和脑脊髓膜病变，脑和脊髓内病变，该病影像特点类似脱髓鞘病变。结论神经型布氏杆菌病临床少见，对反复波动性发热、有疫区居住或牛、羊接触史，合并有神经系统症状、体征者，应及时进行病原学检查，以诊断或排除神经型布氏杆菌病。

Objective To investigate the clinical features of neurobrucellosis .Methods By regression analysis ,clinical manifestation ,epidemiological data ,etiological examination ,lumbar puncture test and neuroimaging features of four neurobrucellosis cases ,who admitted to our hospital from January 2013 to February 2014 ,were investigated combining with literatures on neurobrucellosis to analysis clinical feature of neurobrucellosis .Results Neurobrucellosis mainly affected on brain parenchyma ,spinal cord , spinal nerve root and cerebrospinal meninges on usual .Cerebrospinal fluid usually presented inflammatory changes .Neuroimaging studies could find pathological changes of brain ,spinal cord and cerbrospinal meninges in partial patients ,similar with pathological changes of demyelinate .Conclusions Neurobrucellosis is a kind of relative rare disease in clinical .For patients with undulant fever ,a history of lived in affected areas or contacted with cattle or sheep and related neurological symptoms and signs ,they should have etiological examination on time to make a diagnoses or elimination of neruobrucellosis .