Neurobrucellosis: a Case Report with an Unusual Presentation

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 report: 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 administrated triple therapy for brucellosis for two weeks. A marked improvement of the conscious level was observed, and the patient was back to normal within a few days post-treatment.

Conclusions: We encourage 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.