CLINICAL FEATURES, SEROLOGICALPATTERNS AND LONG-TERM COMPLICATIONS OF 22PATIENTS WITH NEUROBRUCELLOSIS.

Background:- Neurobrucellosis is an endemic zoonotic infection in Saudi Arabia and many parts of the Middle East. The diagnosis of neurobrucellosis poses a challenge to the treating physicians due to the significant variability of its presentation. Different laboratory investigations and treatment regimens have been implemented to diagnose and manage the disease. Since neurobrucellosis is both curable and potentially preventable, the degree of suspicion for neurobrucellosis should be high especially in endemic areas. The aim of our study is to show the different clinical presentations, laboratory findings,complications and different outcomes of neurobrucellosis in our society. Method:-A retrospective analysis of the medical charts of 22 neurobrucellosis patients at King Abdulaziz Medical City (KAMC) in Riyadh during the period between 1995-2010 was carried out. Results:- Fever was the dominant symptom seen in sixteen (73%) patients, followed by anorexia and vomiting reported by eleven (50%) patients each. A history of raw milk ingestion (50%) was commonly seen. Cognitive impairment was the most common finding upon physical examination in 32% of the patients. Mostbut not all of the patients had elevated brucella titer in both CSF and blood while a few patients had positive blood and/or CSF cultures. One patient died acutely secondary to subarachnoid hemorrhage. The most common long-term complications seen were residual weakness and hearing loss in 23% and 9% respectively. Conclusion:- Neurobrucellosis must be kept in mind when evaluating patients with non-specific neurological complaints especially in endemic areas. Early initiation and compliancewith anti-brucella treatment decrease the risk of developing complications.