小儿神经布鲁氏菌病是流行地区常见的人畜共患病,但迄今为止只有轶事报道。在MEDLINE的数据库平台中使用适当的搜索词,SCOPUS和WebofSciences,我们对迄今为止发表在医学文献中的所有小儿神经布鲁氏菌病病例进行了系统回顾,根据病例报告。该方案在PROSPERO(CRD4202233907)下注册。我们的搜索策略产生了187个引用,其中包括51个引用。共审查119例。在这些案件中,其中8人数据不足。最常见的表现是脑膜炎伴或不伴脑炎(n=79,71.2%)。在以外展性麻痹最常见(n=9,8.1%)的儿科人群中,颅神经病的患病率很高(n=22,20.7%)。诊断基于多模式检查,包括标准凝集试验(n=44,39.6%),玫瑰红试验(n=37,33.3%),血培养(n=23,20.7%),血清学(n=20,18.0%)和脑脊液(CSF)培养(n=11,9.9%)。基于利福平的三联药物方案是最常用的(83/102,81.4%)。小儿神经布鲁氏菌病与更高的后遗症频率相关(5.4%),耳聋(2.7%)和死亡率(2.7%),与普通人群相比。神经布鲁氏菌病在各个方面模拟神经结核。该评论强调了该实体在儿童中的几个独特方面。高度怀疑可以确保及时诊断,及时启动管理和有利的结果。
小儿神经布鲁氏菌病是流行地区常见的人畜共患病,但迄今为止只有轶事报道。在MEDLINE的数据库平台中使用适当的搜索词,SCOPUS和WebofSciences,我们对迄今为止发表在医学文献中的所有小儿神经布鲁氏菌病病例进行了系统回顾,根据病例报告。我们的搜索策略产生了187个引用,其中包括51个引用。共审查119例。与最大的神经布鲁氏菌病系列相比,在儿科年龄组中观察到较高的脑膜炎发生率(71.2%vs.37%)。在以外展性麻痹最常见(n=9,8.1%)的儿科人群中,颅神经病的患病率很高(n=22,20.7%)。诊断基于多模式检查,包括标准凝集试验(n=44,39.6%),玫瑰红试验(n=37,33.3%),血培养(n=23,20.7%),血清学(n=20,18.0%)和CSF培养(n=11,9.9%)。基于利福平的三联药物方案是最常用的(83/102,81.4%)。我们的系统评价强调了儿科人群中神经布鲁氏菌病的广泛和异质性表现。高度怀疑可以确保及时诊断,及时启动管理和有利的结果。
Pediatric neurobrucellosis represents a common anthropozoonosis in endemic areas but only anecdotal reports are available till date. Using appropriate search terms in the database platforms of MEDLINE, SCOPUS and Web of Sciences, we performed a systematic review of all the cases of pediatric neurobrucellosis published in the medical literature till date, in the light of a case report. The protocol was registered under PROSPERO (CRD42022333907). Our search strategy yielded 187 citations of which 51 citations were included. A total of 119 cases were reviewed. Of these cases, eight of them had insufficient data. The most common presentation was meningitis with or without encephalitis (n = 79, 71.2%). A high prevalence of cranial neuropathies (n = 22, 20.7%) was observed in the pediatric population in which abducens palsy was the most common (n = 9, 8.1%). Diagnosis was based on multimodal investigations including standard agglutination test (n = 44, 39.6%), Rose Bengal test (n = 37, 33.3%), blood culture (n = 23, 20.7%), serology (n = 20, 18.0%) and cerebrospinal fluid (CSF) culture (n = 11, 9.9%). Rifampicin-based triple drug regimen was the most commonly employed (83/102, 81.4%). Pediatric neurobrucellosis was associated with greater frequency of sequalae (5.4%), deafness (2.7%) and mortality (2.7%), when compared to that of general population. Neurobrucellosis mimics neuro-tuberculosis in various aspects. The review highlights several unique aspects of this entity in children. A high index of suspicion can ensure prompt diagnosis, timely initiation of management and favorable outcomes.
Pediatric neurobrucellosis represents a common zoonosis in endemic areas but only anecdotal reports are available till date. Using appropriate search terms in the database platforms of MEDLINE, SCOPUS and Web of Sciences, we performed a systematic review of all the cases of pediatric neurobrucellosis published in the medical literature till date, in the light of a case report. Our search strategy yielded 187 citations of which 51 citations were included. A total of 119 cases were reviewed. When compared to the largest series in neurobrucellosis, a higher frequency of meningitis was observed in the pediatric age group (71.2% vs. 37%). A high prevalence of cranial neuropathies (n = 22, 20.7%) was observed in the pediatric population in which abducens palsy was the most common (n = 9, 8.1%). Diagnosis was based on multimodal investigations including standard agglutination test (n = 44, 39.6%), Rose Bengal test (n = 37, 33.3%), blood culture (n = 23, 20.7%), serology (n = 20, 18.0%) and CSF culture (n = 11, 9.9%). Rifampicin-based triple drug regimen was the most commonly employed (83/102, 81.4%). Our systematic review highlighted the wide and heterogeneous spectrum of manifestations of neurobrucellosis in the pediatric population. A high index of suspicion can ensure prompt diagnosis, timely initiation of management and favorable outcomes.