Demyelinating steroid-responsive neurobrucellosis

BMJ Case Rep. 2020 Mar 8;13(3):e233798. doi: 10.1136/bcr-2019-233798.

Abstract

Young man with acute onset nausea, vomiting, joint pain, abdominal pain, fever and weight loss was found to have gait ataxia and positive B rucella titres. He deteriorated despite appropriate antibiotics and developed confusion and disorientation. Lumbar puncture revealed lymphocytosis with high protein and low glucose. MRI showed diffuse demyelination. Pulse steroids resulted in rapid clinical, biochemical and radiological recovery.

Keywords: disease and health outcomes; exposures; infection (neurology); medical management; meningitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Brain Diseases / drug therapy*
  • Brain Diseases / microbiology
  • Brucellosis / complications
  • Brucellosis / drug therapy*
  • Demyelinating Diseases / drug therapy*
  • Demyelinating Diseases / microbiology
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Methylprednisolone / therapeutic use*
  • Prednisolone / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Prednisolone
  • Methylprednisolone