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A MENINGITIS CASE OF BRUCELLA AND TUBERCULOSIS CO INFECTION        
Yazarlar
Hasan Karsen
Harran Üniversitesi, Türkiye
Prof. Dr. Mustafa Kasım KARAHOCAGİL Prof. Dr. Mustafa Kasım KARAHOCAGİL
Yüzüncü Yıl Üniversitesi, Türkiye
Hasan Irmak
Ali Pekcan Demiröz
Özet
Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucello and tuberculosis co-infection has been presented. A 19 years old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucella meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucella spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14th day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30th day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucella and tuberculosis co-infection, this report emphasies that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis.
Anahtar Kelimeler
Brucella meningitis | Brucellosis | Coinfection | Tuberculosis | Tuberculous meningitis
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı MIKROBIYOLOJI BULTENI
Dergi ISSN 0374-9096
Dergi Tarandığı Indeksler SCI-Expanded
Makale Dili Türkçe
Basım Tarihi 10-2008
Cilt No 42
Sayı 4
Sayfalar 689 / 694
BM Sürdürülebilir Kalkınma Amaçları
Atıf Sayıları
WoS 6
SCOPUS 6
Google Scholar 12

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