Motor polyradiculoneuropathy as an unusual presentation of neurobrucellosis: a case report and literature review

BMC Infect Dis. 2024 May 14;24(1):491. doi: 10.1186/s12879-024-09365-2.

Abstract

Brucellosis, a zoonotic disease caused by Brucella species, poses a significant global health concern. Among its diverse clinical manifestations, neurobrucellosis remains an infrequent yet debilitating complication. Here, we present a rare case of neurobrucellosis with unusual presentations in a 45-year-old woman. The patient's clinical course included progressive lower extremity weakness, muscle wasting, and double vision, prompting a comprehensive diagnostic evaluation. Notable findings included polyneuropathy, elevated brucella agglutination titers in both cerebrospinal fluid and blood, abnormal EMG-NCV tests, and resolving symptoms with antibiotic therapy. The clinical presentation, diagnostic challenges, and differentiation from other neurological conditions are discussed. This case underscores the importance of considering neurobrucellosis in regions where brucellosis is prevalent and highlights this rare neurological complication's distinctive clinical and radiological features. Early recognition and appropriate treatment are crucial to mitigate the significant morbidity associated with neurobrucellosis.

Keywords: Antibiotic therapy; Blurred vision; Diplopia; EMG-NCV tests; Gait disorder; Intravenous immunoglobulin therapy; Lower extremity weakness; Neurobrucellosis; Polyradiculoneuropathy; Zoonotic disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Brucella / isolation & purification
  • Brucellosis* / complications
  • Brucellosis* / diagnosis
  • Brucellosis* / drug therapy
  • Female
  • Humans
  • Middle Aged
  • Polyradiculoneuropathy* / diagnosis
  • Polyradiculoneuropathy* / microbiology