Neurobrucelose: relato de três casos

Guerreiro, C. A. M.; Scaff, M.; Callegaro, D.; Facure, N. O.; Dianin, V. M. A.

doi:10.1590/S0004-282X1981000200009

Resumos

São relatados dois casos de meningomielite brucelótica e um terceiro caso de hemorragia parenquimatosa e leptomeningite crônica com descrição anátomopatológica. Os autores destacam as formas clínicas e a importância das reações imunológicas no diagnóstico, assim como a necessidade do diagnóstico precose para o tratamento adequado.

Three cases of probable neurobrucellosis are reported. The diagnosis was made on the basis of imunological tests. Two patients with a clinical picture of meningomyelitis showed a definitive clinical improvement under tetraciclin and streptomòcin therapy. The imunological reactions found in the record case were even more positive in the spinal fluid than in the blood. In the case 3 with a clinical presentation of cerebral hemorrage the hitopathological studies demonstrated non specific chronic leptomeningitis and local hemorrages in the caudate nucleus bilaterally. The diagnose and treatment of neurobrucellosis are discussed, stressing the importance of an early therapy.

Neurobrucelose: relato de três casos

Neurobrucellosis: report of three cases

C. A. M. Guerreiro^I; M. Scaff^II; D. Callegaro^III; N. O. Facure^IV; V. M. A. Dianin^V

^IProfessor Assistente do Departamento de Neurologia da FCM-UNICAMP

^IILivre Docente da Clínica Neurológica da FMUSP

^IIIMédico Assistente da Clínica Neurológica da FMUSP

^IVCoordenador do Departamento de Neurologia da FCM-UNICAMP

^VResidente do Departamento de Anatomia Patológica da FCM-UNICAMP

RESUMO

São relatados dois casos de meningomielite brucelótica e um terceiro caso de hemorragia parenquimatosa e leptomeningite crônica com descrição anátomopatológica. Os autores destacam as formas clínicas e a importância das reações imunológicas no diagnóstico, assim como a necessidade do diagnóstico precose para o tratamento adequado.

SUMMARY

Three cases of probable neurobrucellosis are reported. The diagnosis was made on the basis of imunological tests. Two patients with a clinical picture of meningomyelitis showed a definitive clinical improvement under tetraciclin and streptomòcin therapy. The imunological reactions found in the record case were even more positive in the spinal fluid than in the blood. In the case 3 with a clinical presentation of cerebral hemorrage the hitopathological studies demonstrated non specific chronic leptomeningitis and local hemorrages in the caudate nucleus bilaterally. The diagnose and treatment of neurobrucellosis are discussed, stressing the importance of an early therapy.

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Trabalho da Clínica Neurológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP) e da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP).

Clínica Neurológica - Faculdade de Medicina de São Paulo - Caixa Postal 3461 - 01000 São Paulo, SP - Brasil.

1. BOURGEOIS, M. & TIGNOL, J. - Neuro-brucellose: troubles mentaux et comitialité. Rev. Neurol. (Paris). 124:303, 1971.
2. BUCHAN, T. M.; FABER, L. C. & FELDMAN, R. A. - Brucellosis in the United Stades, 1960-1972. Medicine 53:403, 1974.
3. CARELS, G. & HENNEAUX, J. - Une forme chronique de neurobrucellose. Acta neurol. psychiat. beg. 64:777, 1964.
4. CASTAÑEDA, M. R.; LOUZADA, A. P. & VERONESI, R. - Doenças Infecciosas e Parasitárias. 6Ş edição, cap. 48, pp. 421-430, Guanabara-Koogan, 1976.
5. CASTLEMAN, B. & Mc NEELY, B. V. - Case records of the Massachusetts General Hospital. New England J. Med. 282:153, 1970.
6. DE VILLAFANE LASTRA, T. - Epidemiology and neurological manifestations of brucellosis. In L. Van Bogaert; J. P. Kafer & G. F. Poch, eds. - Tropical Neurology. Lopez Libreros, Buenos Aires, pp. 302-325, 1963.
7. DI CARLO, F. C; ABDALA, J.; RAMACCIOTTI, F. & SANTOLAYA, A. - Tra-tamiento de la brucelosis crônica con la oxitetraciclina anfotérica. Prensa med. Argentina 50:2093, 1963.
8. FINCHAM, R. W.; SAHS, A. L. & JOYNT, R. J. - Protean manifestations of nervous system brucellosis. J. A. M. A. 184:269, 1963.
9. GLASGOW, M. M. S. - Brucellosis of the spine. British J. Surg. 63:283, 1976.
10. KERR, W. R.; Mc CAUGHEY, W. J.; COGHLAN, J. D.; PAYNE, D. J. H.; QUAIFE, R. A.; ROBERTSON, L. & FARREL, I. D. - Techniques and Interpretations in the serological diagnosis of brucellosis in man. J. med. Microbiol. 1:181. 1968.
11. Leading Lancet article - Brucellosis. Lancet 1:436, 1975.
12. LARBRISSEAU, A.; MARAVI, E.; AGUILERA, F. & MARTINEZ-LAGE, J. M. - The neurological complications of brucellosis. Canadien Sciences Neurol. 5:369, 1978.
13. LAWSON, J. H. - Clinical aspects of brucellosis. Scot. med. J. 21:128, 1976.
14. MELLO, M. T. - A brucelose e sua profilaxia no Brasil. O Hospital 53:683, 1958.
15. Mc ALLISTER, T. A. - Laboratory diagnosis of human brucellosis. Scot med. J. 2:129, 1976.
16. MIZON, J. P.; GENTIT, F.; LAURANS, A.; FROISSART, M. & DESTEE, A. Meningo-encéphalite et polyradiculonévrite d'origine brucellienne Nouv. Prèsse méd. 25:1587, 1976.
17. NELSON-JONES, A.: Neurological complications of undulant fever: the clinical picture. Lancet 1:495, 1951.
18. NICHOLS, E. - Meningo-encephalitis due to brucellosis with the report of a case in wich Brucella abortus was recovered from cerebrospinal fluid, and a review of the literature. Ann. Intern. Med. 35:673, 1951.
19. PEARSON, A. D.; SCARFE, S.; MORGAN, T. A. & POLLARD, R. - Evidence of a pattern in the variable host response to brucella in man. Lancet 1:593, 1973.
20. PEDRO-PONS, A.; FOZ, M.; CODINA, A. è RET, C. - Les neurobrucelloses: étude de 41 cas. Cahiers de Médicine (Europa Medica) 13:855, 1972.
21. PORTER, I. A. - Pathogenesis of brucellosis. Scot. med. J. 21:126, 1976.
22. REID, D. - Epidemiology of human brucellosis. Scot. med. J. 21:125, 1976.
23. RISER, M.; GÉRAUD, J.; RASCOL, A. & BES, A. - Les méningo-encéphalites mélitococciques tardives cliniquement primitives. Rev. neurol. (Paris) 104:403, 1971.
24. SAHADEVAN, M. G.; SINGH, M.; JOSEPH, P. P. & HOON, R. S. - Menin-gomyelitis due to brucellosis. British, med. J. 4:432, 1969.
25. SAHS, A. L. - Brucellosis. In P. J. Vinken & G. W. Bruyn, eds. - Handbook of Clinical Neurology, vol. 33, cap. 15, pp. 305-326, 1978.
26. SMITH, C. C. - Treatment of human brucellosis. Scot. med. J. 21:132, 1976.
27. SPINK, W. W. - What is chronic brucellosis? Ann. Intern. Med. 35:358, 1951.

Datas de Publicação

Publicação nesta coleção
20 Ago 2012
Data do Fascículo
Jun 1981

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BOURGEOIS, M. & TIGNOL, J. - Neuro-brucellose: troubles mentaux et comitialité. Rev. Neurol. (Paris). 124:303, 1971.

[2] 2. BUCHAN, T. M.; FABER, L. C. & FELDMAN, R. A. - Brucellosis in the United Stades, 1960-1972. Medicine 53:403, 1974.

[3] 3. CARELS, G. & HENNEAUX, J. - Une forme chronique de neurobrucellose. Acta neurol. psychiat. beg. 64:777, 1964.

[4] 4. CASTAÑEDA, M. R.; LOUZADA, A. P. & VERONESI, R. - Doenças Infecciosas e Parasitárias. 6Ş edição, cap. 48, pp. 421-430, Guanabara-Koogan, 1976.

[5] 5. CASTLEMAN, B. & Mc NEELY, B. V. - Case records of the Massachusetts General Hospital. New England J. Med. 282:153, 1970.

[6] 6. DE VILLAFANE LASTRA, T. - Epidemiology and neurological manifestations of brucellosis. In L. Van Bogaert; J. P. Kafer & G. F. Poch, eds. - Tropical Neurology. Lopez Libreros, Buenos Aires, pp. 302-325, 1963.

[7] 7. DI CARLO, F. C; ABDALA, J.; RAMACCIOTTI, F. & SANTOLAYA, A. - Tra-tamiento de la brucelosis crônica con la oxitetraciclina anfotérica. Prensa med. Argentina 50:2093, 1963.

[8] 8. FINCHAM, R. W.; SAHS, A. L. & JOYNT, R. J. - Protean manifestations of nervous system brucellosis. J. A. M. A. 184:269, 1963.

[9] 9. GLASGOW, M. M. S. - Brucellosis of the spine. British J. Surg. 63:283, 1976.

[10] 10. KERR, W. R.; Mc CAUGHEY, W. J.; COGHLAN, J. D.; PAYNE, D. J. H.; QUAIFE, R. A.; ROBERTSON, L. & FARREL, I. D. - Techniques and Interpretations in the serological diagnosis of brucellosis in man. J. med. Microbiol. 1:181. 1968.

[11] 11. Leading Lancet article - Brucellosis. Lancet 1:436, 1975.

[12] 12. LARBRISSEAU, A.; MARAVI, E.; AGUILERA, F. & MARTINEZ-LAGE, J. M. - The neurological complications of brucellosis. Canadien Sciences Neurol. 5:369, 1978.

[13] 13. LAWSON, J. H. - Clinical aspects of brucellosis. Scot. med. J. 21:128, 1976.

[14] 14. MELLO, M. T. - A brucelose e sua profilaxia no Brasil. O Hospital 53:683, 1958.

[15] 15. Mc ALLISTER, T. A. - Laboratory diagnosis of human brucellosis. Scot med. J. 2:129, 1976.

[16] 16. MIZON, J. P.; GENTIT, F.; LAURANS, A.; FROISSART, M. & DESTEE, A. Meningo-encéphalite et polyradiculonévrite d'origine brucellienne Nouv. Prèsse méd. 25:1587, 1976.

[17] 17. NELSON-JONES, A.: Neurological complications of undulant fever: the clinical picture. Lancet 1:495, 1951.

[18] 18. NICHOLS, E. - Meningo-encephalitis due to brucellosis with the report of a case in wich Brucella abortus was recovered from cerebrospinal fluid, and a review of the literature. Ann. Intern. Med. 35:673, 1951.

[19] 19. PEARSON, A. D.; SCARFE, S.; MORGAN, T. A. & POLLARD, R. - Evidence of a pattern in the variable host response to brucella in man. Lancet 1:593, 1973.

[20] 20. PEDRO-PONS, A.; FOZ, M.; CODINA, A. è RET, C. - Les neurobrucelloses: étude de 41 cas. Cahiers de Médicine (Europa Medica) 13:855, 1972.

[21] 21. PORTER, I. A. - Pathogenesis of brucellosis. Scot. med. J. 21:126, 1976.

[22] 22. REID, D. - Epidemiology of human brucellosis. Scot. med. J. 21:125, 1976.

[23] 23. RISER, M.; GÉRAUD, J.; RASCOL, A. & BES, A. - Les méningo-encéphalites mélitococciques tardives cliniquement primitives. Rev. neurol. (Paris) 104:403, 1971.

[24] 24. SAHADEVAN, M. G.; SINGH, M.; JOSEPH, P. P. & HOON, R. S. - Menin-gomyelitis due to brucellosis. British, med. J. 4:432, 1969.

[25] 25. SAHS, A. L. - Brucellosis. In P. J. Vinken & G. W. Bruyn, eds. - Handbook of Clinical Neurology, vol. 33, cap. 15, pp. 305-326, 1978.

[26] 26. SMITH, C. C. - Treatment of human brucellosis. Scot. med. J. 21:132, 1976.

[27] 27. SPINK, W. W. - What is chronic brucellosis? Ann. Intern. Med. 35:358, 1951.