Psödotümör serebriyi taklit eden brusellozun neden olduğu bilateral papil ödem

Bu yazıda, psödotümör serebri ön tanısıyla hastaneye yatırılan ve izole intrakraniyal hipertansiyon prezentasyonu ile nö - robruselloz tanısı alan migrenli bir hastayı sunuyoruz. Yirmi iki yaşında kadın hasta, acil servise baş ağrısı yakınmasıyla başvurdu. Öyküsünde yedi yıldır migren tanısı olduğu belirtildi. Nörolojik muayenesinde bilateral papilödem saptandı. Kra- niyal manyetik rezonans görüntüleme normaldi. Beyin omurilik sıvısı incelemesinde mm3 başına 80 lenfosit ile 178 mg/dL protein saptandı. Açılış basıncı 260 mmH2O idi. Brucella standart tüp aglütinasyonu ve Rose Bengal testleri kanda ve beyin omurilik sıvısında pozitifti. Nörobruselloz tanısı koyuldu. Sistemik bulguların silik, nörolojik bulguların izole papilödemi gibi atipik olması durumunda nörobruselloz düşünülmeyebilir ve tanısı gecikebilir. Endemik alanlarda tanı protokolleri içinde Brucella serolojisinin yer alması gerektiğini düşünüyoruz. Böylece, erken tanı ve uygun tedavi ile nörobruselloz komplikas- yonlarının önüne geçilebilir.

Bilateral papilledema caused by brucellosis mimicking pseudotumor cerebri

In this article, we report a patient with migraine who was hospitalized with a prediagnosis of pseudotumor cerebri and diagnosed as neurobrucellosis with isolated intracranial hypertension presentation. A 22-year-old woman was admitted to emergency department with a complaint of headache. Her anamnesis indicated that she had migraine for 7 years. Neuro- logical examination revealed bilateral papilledema. Cranial magnetic resonance imaging was normal. Cerebrospinal fluid (CSF) examination revealed 80 lymphocytes per mm3 with 178 mg/dL protein. Opening pressure was 260 mmH2O. Brucella tube agglutination and Rose Bengal tests were positive in blood and CSF. She was diagnosed as neurobrucellosis. If the systemic findings are insignificant and neurological findings are atypical such as isolated papillary edema, neurobrucel- losis may not be considered and its diagnosis may be delayed. We believe that brucella serology should be included in the diagnostic protocols in endemic areas. Thus, early diagnosis and appropriate treatment can prevent complications of neurobrucellosis.

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