Neurobrucellosis

Question 1

Neurobrucellosis

Answer 1

Causative agent:
* Brucella bacteria which has multiple species: SAM
* B. Suis
* B. Melitensis : the most virulent
* B. Abortus.

Question 2

Neurobrucellosis

Answer 2

Mode of Transmission:
* Ingestion of unpasteurized milk products or undercooked meat.
* Inhalation of aerosol infected milk products.
* Direct contact or inoculation through skin or conjunctiva.
* Transmission from human to human is rare.

Question 3

Neurobrucellosis

Answer 3

Pathophysiology:
* Lipopolysaccharide (LPS) Ags
1-Bacteria enter body leading to activation of macrophages ….. intracellular multiplication ……….. RES organs ……. blood …… organs (Spleen, Liver, BM).
2- Brucella can cross BBB, cause nerve damage, granuloma in CNS. Can pass direct with blood circulation.

Question 4

Neurobrucellosis

Answer 4

IP:
* 2-4 w up to 6-12 M
* Infection can persist for months before symptoms.

Question 5

Neurrobrucellosis

Answer 5

C/p
Neurological signs may occur in 5% of cases:
* Meningitis
* Meningo-encephalitis
* Myelitis
* Brain abscess
* Epidural abscess
* Granuloma
* Demyelinating & Meningo vascular signs
Symptoms may include neck stiffness, fever, depression, confusion.

Question 6

Neurobrucellosis

Answer 6

Investigations:
1- Culture:
* BM Culture is the gold standard for diagnosis.
* Blood Culture.
2- SAT “Serum Agglutination Test”: يستخدم لتشخيص الحمى المالطية والبروسيلا.
3-ELISA: To detect IgG, IgM, IgA.
4- Rose Bengal Test: For screening in animals.
5-PCR