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Intramedullary Brucellosis

  • Erdal KalkanEmail author
  • Fatih Erdi
  • Ahmet Tuncay Turgut
  • Bülent Kaya
Chapter

Abstract

Human neurobrucellosis has a broad spectrum of clinical manifestations depending on the stage of the infection and affected part of the nervous system. Neurobrucellosis is the second most common and severely debilitating complication of the systemic brucellosis and may occur at any stage, even years after and without the sytemic symptoms. Clinically, neurobrucellosis can present in an acute form as meningitis, meningoencephalitis, myelopathy, or neuropathy; in chronic form as granuloma, demyelinization, or degeneration; or in any combination of these. In this chapter, we analyze the etiology, physiopathology, clinical picture, diagnosis, and management of intramedullary brucellosis in detail.

Keywords

Abscess Brucella Granuloma Intramedullary Neurobrucellosis 

Abbreviations

CSF

Cerebrospinal fluid

CT

Computed tomography

MRI

Magnetic resonance imaging

PET/CT

Positron emission tomography combined with computed tomography

References

  1. 1.
    Bingöl A, Yücemen N, Meço O (1999) Medically treated intraspinal “Brucella” granuloma. Surg Neurol 52:570–576CrossRefPubMedGoogle Scholar
  2. 2.
    Cokça F, Meço O, Arasil E, Unlu A (1994) An intramedullary dermoid cyst abscess due to Brucella abortus biotype 3 at T11-L2 spinal levels. Infection 22:359–360CrossRefPubMedGoogle Scholar
  3. 3.
    al Deeb SM, Yaqub BA, Sharif HS, Phadke JC (1989) Neurobrucellosis: clinical characteristics, diagnosis, and outcome. Neurology 39:498–501CrossRefPubMedGoogle Scholar
  4. 4.
    Franco MP, Mulder M, Gilman RH, Smits HL (2007) Human brucellosis. Lancet Infect Dis 7:775–786CrossRefPubMedGoogle Scholar
  5. 5.
    Harman M, Unal O, Onbaşi KT, Kiymaz N, Arslan H (2001) Brucellar spondylodiscitis: MRI diagnosis. Clin Imaging 25:421–427CrossRefPubMedGoogle Scholar
  6. 6.
    Helvaci M, Kasirga E, Cetin N, Yaprak I (2002) Intramedullary spinal cord abscess suspected of Brucella infection. Pediatr Int 44:446–448CrossRefPubMedGoogle Scholar
  7. 7.
    Hendam AT, Barayan SS, Anazi AH Al (2014) Cervical intramedullary brucellosis: a case report. Neurosurg Q 24:203–206Google Scholar
  8. 8.
    Ioannou S, Chatziioannou S, Pneumaticos SG, Zormpala A, Sipsas NV (2013) Fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography scan contributes to the diagnosis and management of brucellar spondylodiskitis. BMC Infect Dis 13:73CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Keihani-Douste Z, Daneshjou K, Ghasemi M (2006) A quadriplegic child with multiple brain abscesses: case report of neurobrucellosis. Med Sci Monit 12:119–122Google Scholar
  10. 10.
    Nas K, Tasdemir N, Cakmak E, Kemaloglu MS, Bukte Y, Geyik MF (2007) Cervical intramedullary granuloma of Brucella: a case report and review of the literature. Eur Spine J 16(Suppl 3):2559Google Scholar
  11. 11.
    Novati R, Viganò MG, de Bona A, Nocita B, Finazzi R, Lazzarin A (2002) Neurobrucellosis with spinal cord abscess of the dorsal tract: a case report. Int J Infect Dis 6:149–150CrossRefPubMedGoogle Scholar
  12. 12.
    Solera J, Lozano E, Martinez-Alfaro E, Espinosa A, Castillejos ML, Abad L (1999) Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis 29:1440–1449CrossRefPubMedGoogle Scholar
  13. 13.
    Tali ET, Gültekin S (2005) Spinal infections. Eur Radiol 15:599–607CrossRefPubMedGoogle Scholar
  14. 14.
    Talı ET, Koc AM, Oner AY (2015) Spinal brucellosis. Neuroimaging Clin N Am 25:233–245CrossRefPubMedGoogle Scholar
  15. 15.
    Tufan K, Aydemir F, Sarica FB, Kursun E, Kardes Ö, Cekinmez M, Caner H (2014) A extremely rare case of cervical intramedullary granuloma due to Brucella accompanied by Chiari type 1 malformation. Asian J Neurosurg 9:173–176CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Turgut M, Cullu E, Sendur OF, Güyrer G (2004) Brucellar spine infection-four case reports. Neurol Med Chir (Tokyo) 44:562–567CrossRefGoogle Scholar
  17. 17.
    Turgut M, Sendur OF, Gürel M (2003) Brucellar spondylodiscitis in the lumbar region. Neurol Med Chir (Tokyo) 43:210–212CrossRefGoogle Scholar
  18. 18.
    Turgut M, Turgut AT, Koşar U (2006) Spinal brucellosis: Turkish experience based on 452 cases published during the last century. Acta Neurochir (Wien) 148:1033–1044CrossRefGoogle Scholar
  19. 19.
    Vajramani GV, Nagmoti MB, Patil CS (2005) Neurobrucellosis presenting as an intra-medullary spinal cord abscess. Ann Clin Microbiol Antimicrob 4:14CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Erdal Kalkan
    • 1
    Email author
  • Fatih Erdi
    • 1
  • Ahmet Tuncay Turgut
    • 2
  • Bülent Kaya
    • 1
  1. 1.Department of NeurosurgeryNecmettin Erbakan University, Meram Faculty of MedicineKonyaTurkey
  2. 2.Department of RadiologyHacettepe University School of MedicineAnkaraTurkey

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