A case of neurobrucellosis

Abstract

Brucellosis is a multisystemic disease that may present with a broad spectrum of clinical manifestations and complications. Neurological symptoms are common in brucellosis. Neurobrucellosis associated with central nervous system involvement is a rare clinical form of disease, (1.7-7% of prevalence). A 50-year-old man presented with confusion, bilateral vestibulocochlear nerve paralysis, symptoms of cerebellar dysfunction, atrophy and paralysis of multiple muscles. Involvement of both central and peripheral nervous system as well as the production of Brucella melitensis in the cerebro-spinal fluid culture was thought to be eligible for presentation. In laboratory tests; Rose-Bengal test in blood serum was positive; brucella tube agglutination test was 1/160 positive and Brucella melitensis was reproduced in cerebro-spinal fluid culture. He was treated with rifampicin (600 mg/day), doxycycline (200 mg/day) and ceftriaxone (2000 mg/day) combination. After one month, the patient was hospitalized for a second time as symptoms and findings of prior clinical picture were again detected. Rose-Bengal in blood serum, Brucella tube agglutination (1/160 titration) and Brucella tube agglutination with coombs (1/160 titration) tests were positive. In conclusion; in a case of subacute progressive neurobrucellosis, successful results may be attained by application of a proper antibacterial combination in a sufficient dose and for a sufficient time period.

Keywords

• Brucellosis; central nervous system; neurobrucellosis; peripheral nervous system; treatment

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