Nederlands Tijdschrift voor Geneeskunde
Volume 161, Issue 47, 2017

A 14-year-old syrian refugee with neurobrucellosis [Een 14-jarige Syrische vluchteling met neurobrucellose] (Article)

Quaak M.S.W.* , Bavelaar H.H.J. , Berkhout J. , Truin G.J. , Bijker E.M.
  • a Radboudumc Amalia Kinderziekenhuis, Afd. Kindergeneeskunde, Nijmegen, Netherlands, Canisius Wilhelmina Ziekenhuis, Nijmegen, Netherlands
  • b Radboudumc Amalia Kinderziekenhuis, Afd. Kindergeneeskunde, Nijmegen, Netherlands, Afd. Medische Microbiologie en Infectieziekten, Netherlands
  • c Radboudumc Amalia Kinderziekenhuis, Afd. Kindergeneeskunde, Nijmegen, Netherlands, Afd. Medische Microbiologie en Infectieziekten, Netherlands
  • d Radboudumc Amalia Kinderziekenhuis, Afd. Kindergeneeskunde, Nijmegen, Netherlands, Afd. Kindergeneeskunde, Netherlands
  • e Radboudumc Amalia Kinderziekenhuis, Afd. Kindergeneeskunde, Nijmegen, Netherlands, Canisius Wilhelmina Ziekenhuis, Nijmegen, Netherlands

Abstract

Background: Neurobrucellosis is a rare complication of brucellosis, a bacterial zoonotic disease endemic in regions such as the Middle East. It is important to be alert for this imported disease in the Netherlands as well, especially among migrants. Case description: A 14-year-old boy from Syria presented with headache, vomiting and weight loss. Brucella melitensis was identified in the cerebrospinal fluid. The patient's condition deteriorated despite antibiotic treatment, particularly neurologically, and imaging revealed a newly developed hydrocephalus. The symptoms disappeared after placement of a temporary external ventricular drain. The patient made a complete recovery following 8 months of continual antibiotic therapy. Conclusion: Diagnosis and treatment were delayed, partly because there were no medical records available, previous treatment had been interrupted when the patient fled the country, and the language barrier. Knowledge of previous medical history and of the epidemiology of infectious diseases in the land of origin is particularly important when treating migrants. Treating brucellosis with antibiotics can lead to clinical deterioration due to a Jarisch-Herxheimer-like phenomenon.

Author Keywords

[No Keywords available]

Index Keywords

Netherlands refugee vomiting Syrian Arab Republic human epidemiology Refugees neurobrucellosis Brucella melitensis antibiotic agent Animals ethnology animal Humans treatment duration Adolescent weight reduction male headache case report hydrocephalus clinical article neuroimaging isolation and purification Article brucellosis Syrian cerebrospinal fluid antibiotic therapy Syria antiinfective agent Anti-Bacterial Agents deterioration
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85037153280&partnerID=40&md5=bb6ff0afbe3afc66e6532ea60340a654
ISSN: 00282162
Original Language: Dutch