OUTCOME OF NEUROBRUCELLOSIS FOCUSED ON TREATMENT

Shemsedin Dreshaj, Nexhmedin Shala, Gresa Dreshaj, Ekrem Ismani, Bujar Gjikolli

Abstract

Background: This study aimed to analyze the outcome of neurobrucellosis according to treatment. Material/Methods: A cross-sectional epidemiologic survey was carried out in 648 patients with brucellosis hospitalized in Infectious Diseases Clinic, UCC of Kosova. Among them 82 patients fulfill criteria for neurobrucellosis and were analyzed regarding medication and outcome. Results: The mean age of patients with neurobrucellosis was 31.46 years, with age distribution 12-71 years. In this retrograde study the most often presentation of neurobrucellosis was affection of PNS in 34 (41, 46%), meningitis 28 (34.14%), and cranial nerve damages in 20 (24.39%). Radiculopathies of legs (41.46%) was leading finding followed by neck rigidity (46.34%). Clinically in admission patient present agitation (25,6%), behavioral disorders (18.3%) and disorientation (19.5%). Cranial nerves were involved in (24.4%). Five patients (6.1%) leave hospital with severe consequences, three patients with peripheral facial paresis, two with sensori-neural hearing loss and one with left hemiparesis. Leading complains for hospitalization improved in most patients after 6 weeks of treatment, which demonstrated a favorable efficacy. Cross-sectional epidemiologic survey suggested that sex and regional distribution were not related to nervous system damage (P>0.05), whereas duration of disease, prior to treatment, were related factor. From a totally 82 patients with neurobrucellosis, 43 patients are treated for 12 weeks, 34 for 24 weeks and 5 for 36 weeks. The shorter duration of treatment without relapses was 24 week. Conclusions: In endemic areas for brucellosis patients complaining in radiculopathies, persistent headache, facial palsy, hearing loss or presenting stroke without risk factors, should be considered for screening for neurobrucellosis. Based on our data, according to treatment and clinical follow-up, 24 weeks of antibiotic therapy in neurobrucellosis seems adequate. Duration of disease is risk factors for neurobrucellosis.

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