改良抗酸染色阳性的神经型布氏杆菌病二例

Two cases of neurobrucellosis with positive modified Ziehl-Neelsen stain

目的分析神经型布氏杆菌病(NB)的临床表现、诊疗方法,探讨改良抗酸染色的诊断价值。方法分析河北医科大学第二医院2015年收治的2例NB住院患者临床资料。结果 (1)例1患者以头痛、发热、视物成双等神经系统症状首发,曾被误诊为病毒性脑炎。例2患者以泌尿系感染为首发症状,起初误诊泌尿系感染;(2)2例患者起初误诊后均通过追溯流行病学接触史以及血清学检测确诊NB;(3)本文2例患者脑脊液(CSF)行改良抗酸染色均出现阳性。结论 NB患者脑脊液细胞学(CSFC)改良抗酸染色可以出现阳性,但同时还应注意与结核性脑膜炎相鉴别。

Objective To investigate the clinical manifestation,diagnosis and treatment methods ofneurobrucellosis(NB),as well as the diagnostic value of modified Ziehl-Neelsen stain to this disease.Method information of two patients who were hospitalized in the Second Hospital of Hebei Medical University in2015wereanalyzed.Results①Case1was started with nervous system symptoms such as headache,fever and blurred visionthat misdiagnosed as viral encephalitis at early time.Case2was misdiagnosed as urinary tract infection at first;②Two cases were confirmed as NB after misdiagnosed early through retrospective epidemiological contact historyand serological examination finally;③Two cases had positive modified Ziehl-Neelsen stain for cerebrospinal fluidsamples.Conclusion The modified Ziehl-Neelsen stain of cerebrospinal fluid samples for neurobrucellosis could bepositive,but it was necessary to identify with tuberculous meningitis.