Title:Neurobrucellosis: A Case Report with an Unusual Presentation
Volume: 16
Issue: 1
Author(s): Mostafa Meshref, Yara Amro and Mahmoud A. Ebada*
Affiliation:
- Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia,Egypt
Keywords:
Brucella, neurobrucellosis, neurological symptoms, animals, treatment, CSF analysis.
Abstract:
Background: Brucellosis is a highly infectious multi-systemic zoonosis,
and it is caused by Gram-negative bacteria, Brucella. Despite the low incidence
of neurobrucellosis, it is the most dangerous consequence of brucellosis.
Case Presentation: A 30-year-old Sudanese male patient presented to our hospital
with a complaint of fever associated with confusion for three days. He had
signs of meningeal irritation in the form of neck stiffness, positive Kernig’s, and
Lesage’s sign. The computerized tomography of the brain was normal. The CSF
analysis showed a clear colorless sample with normal tension, decreased glucose,
and slightly increased CSF protein level. We reviewed his occupational history;
the patient was a farmer with regular contact with cattle and camels. The patient
had positive Brucella antibodies for both B. Abortus and B. melitensis with a
high titer (1/640). As described in various patents, we administered triple therapy
for brucellosis for two weeks. A marked improvement in the conscious level was
observed, and the patient was back to normal within a few days post-treatment.
Conclusion: We encouraged physicians to consider the diagnosis of neurobrucellosis
with any neurologic sign without a known cause. Our case highlights the importance
of occupational history in clinical medicine.
