{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T14:53:19Z","timestamp":1782571999872,"version":"3.54.5"},"reference-count":20,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    A 65-year-old man developed a leukoencephalopathy associated with neurobrucellosis. The disease followed a 15-month progressive course with neurologic symptoms, and magnetic resonance imaging revealed bilateral symmetrical T2 signal hyperintensities in the white matter. Biopsy of the cerebral cortex and white matter was significant for nongranulomatous meningoencephalitis with reactive microgliosis and astrogliosis. The inflammatory infiltrate was predominantly composed of T lymphocytes, including numerous cytotoxic T cells. There was no evidence of significant myelin destruction. No organisms were detected microscopically, but elevated immunoglobulin G titers to\n                    <jats:italic>Brucella<\/jats:italic>\n                    were found in the cerebrospinal fluid. An abscess formed at the biopsy site, and\n                    <jats:italic>Brucella melitensis<\/jats:italic>\n                    was cultured from abscess contents. Neurobrucellosis is difficult to diagnose outside endemic regions and is associated with leukoencephalopathy-like pathology. Cytotoxic T lymphocytes and microglia activation play an immunopathogenic role in this rare disease.\n                  <\/jats:p>","DOI":"10.5858\/2003-127-e374-npaltr","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T10:00:45Z","timestamp":1612778445000},"page":"e374-e377","source":"Crossref","is-referenced-by-count":42,"title":["Neurobrucellosis Presenting as Leukoencephalopathy: The Role of Cytotoxic T Lymphocytes"],"prefix":"10.5858","volume":"127","author":[{"given":"Gregory","family":"Seidel","sequence":"first","affiliation":[{"name":"From the Departments of Pathology (Drs Seidel, Pardo, and Eberhart), Neurology (Drs Pardo and Newman-Toker), and Neurosurgery (Dr Olivi), Johns Hopkins University School of Medicine, Baltimore, Md"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Pardo","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Seidel, Pardo, and Eberhart), Neurology (Drs Pardo and Newman-Toker), and Neurosurgery (Dr Olivi), Johns Hopkins University School of Medicine, Baltimore, Md"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Newman-Toker","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Seidel, Pardo, and Eberhart), Neurology (Drs Pardo and Newman-Toker), and Neurosurgery (Dr Olivi), Johns Hopkins University School of Medicine, Baltimore, Md"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Olivi","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Seidel, Pardo, and Eberhart), Neurology (Drs Pardo and Newman-Toker), and Neurosurgery (Dr Olivi), Johns Hopkins University School of Medicine, Baltimore, Md"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles G.","family":"Eberhart","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Drs Seidel, Pardo, and Eberhart), Neurology (Drs Pardo and Newman-Toker), and Neurosurgery (Dr Olivi), Johns Hopkins University School of Medicine, Baltimore, Md"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"key":"i1543-2165-127-9-e374-b1","series-title":"Emerging Infect Dis","first-page":"213","article-title":"Brucellosis: an overview.","volume":"3","author":"Corbel, M. J.","year":"1997","unstructured":"Corbel, M. J.\n          \n          Brucellosis: an overview.\n          Emerging Infect Dis\n          1997. 3:213\u2013221."},{"key":"i1543-2165-127-9-e374-b2","series-title":"J Assoc Physicians India","first-page":"376","article-title":"Clinical profile of neurobrucellosis\u2014a report on 12 cases from Bikaner (north-west India).","volume":"48","author":"Kochar, D. K.","year":"2000","unstructured":"Kochar, D. K., N.Agarwal, N.Jain, B. V.Sharma, A.Rastogi, and C. B.Meena. Clinical profile of neurobrucellosis\u2014a report on 12 cases from Bikaner (north-west India).J Assoc Physicians India2000. 48:376\u2013380."},{"key":"i1543-2165-127-9-e374-b3","series-title":"Acta Neurol Scand","first-page":"282","article-title":"Localized CNS brucellosis: report of 7 cases.","volume":"78","author":"Pascual, J.","year":"1988","unstructured":"Pascual, J., O.Combarros, J. M.Polo, and J.Berciano. Localized CNS brucellosis: report of 7 cases.Acta Neurol Scand1988. 78:282\u2013289."},{"key":"i1543-2165-127-9-e374-b4","series-title":"Curr Opin Microbiol","first-page":"58","article-title":"Brucellosis: a worldwide zoonosis.","volume":"4","author":"Boschiroli, M. L.","year":"2001","unstructured":"Boschiroli, M. L., V.Foulongne, and D.O'Callaghan. Brucellosis: a worldwide zoonosis.Curr Opin Microbiol2001. 4:58\u201364."},{"issue":"249","key":"i1543-2165-127-9-e374-b5","series-title":"Q J Med","first-page":"39","article-title":"Human brucellosis in Kuwait: a prospective study of 400 cases.","volume":"66","author":"Lulu, A. R.","year":"1988","unstructured":"Lulu, A. R., G. F.Araj, M. I.Khateeb, M. Y.Mustafa, A. R.Yusuf, and F. F.Fenech. Human brucellosis in Kuwait: a prospective study of 400 cases.Q J Med1988. 66249:39\u201354."},{"key":"i1543-2165-127-9-e374-b6","series-title":"Eur Neurol","first-page":"238","article-title":"Neurobrucellosis mimicking multiple sclerosis: a case report.","volume":"29","author":"Bussone, G.","year":"1989","unstructured":"Bussone, G., L.La Mantia, L.Grazzi, E.Lamperti, A.Salmaggi, and L.Strada. Neurobrucellosis mimicking multiple sclerosis: a case report.Eur Neurol1989. 29:238\u2013240."},{"key":"i1543-2165-127-9-e374-b7","series-title":"Rev Neurol","first-page":"781","article-title":"Regressive leukoencephalopathy in chronic brucellosis.","volume":"153","author":"Krystkowiak, P.","year":"1997","unstructured":"Krystkowiak, P., P.Vermersch, G.Beaucaire, and H.Petit. 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