New serovars of Leptospira in Iran: Australis and Tarassovi

Abstract

Background: Brucellosis is a chronic granulomatous infection nd neurobrucellosis is a rare neurological complication of brucelosis. Methods:We evaluate 19 patients with neurobrucellosis in our ospitals during 8 years. Neurobrucellosis was diagnosed in 19 atients out of 235 patients with brucellosis at our institutions.We eviewed their symptoms, signs and paraclinical data. All patients ere followed for two years to find any signs and symptoms of elapse. Results: Two hundred thirty five patients were diagnosed as rucellosis and admitted at two tertiary care hospitals during eight ears period. 19 patients (8%) had neurobrucellosis. Of them 14 74%) were male and 5 (26%) were female. The most common igns and symptomswereheadache (79%), fever (84%), neck rigidity 42%), fatigue (37%), drowsiness (31%), inappropriate speech (21%), ausea and vomiting (15%). Ten (58%) patients had focal neurologcal deficits. The duration of symptoms varied from one week to our months before definite diagnosis. CSF analysis showed noral CSF protein in five (26%) patients. CSF glucose was low in nine 47%) patients. Ten (53%) patients had normal CSF glucose. CSF BC count was between 6 cells/dl and 3600 cells/dl with mean ount 403 cells/dl. CSF cultures and Gram-stains were negative in ll patients. Serumanti-brucella IgG and IgMantibodywas checked or patients who had negative Coomb’s wright tests results by nzyme-linked immunosorbant assay (ELISA) method. Neurobruellosis was diagnosed by detection of anti-brucella antibodies in he CSF by either ELISA or Coomb’swright tests. Hydrocephalus and utamen infarctionwasdetected inMRIof twopatients. Eight (42%) atients received 8-14 weeks antibiotic therapy. One patient who howed right lower extremity weakness and peripheral neuropahy in nerve conduction velocity study received 1.5 year antibiotic herapy. Other patients had received 6 months antibiotic therapy. Conclusion: Clinicians in endemic areas should consider the ikelihood of neurobrucellosis in patients with unexplained neuological and psychiatric symptoms.