Report of one case of neurobrucellosis

ABSTRACT

The neurobrucellosis can affect any part of the central or peripheral nervous system. The clinical syndromes are ultimately diverse and clinical picture may be confused by the coexistence of two or more clinical syndromes in the same patient. The most common neurologic manifestation is a sub-acute or chronic meningoencephalitis. Acute toxic manifestations [e.g., headache, neck ache, backache, insomnia, depression and muscle weakness] are seen during the acute phase of infection. Incidence of neurobrucellosis cannot be exactly estimated. The most important clinical syndromes include Brucella meningitis and encephalitis, vascular syndromes, myelopathy and spinal disease and psychiatric disturbances. Diagnosis is made by reviewing patient history, physical examination, CSF and serum serological and other laboratory studies. Treatment is difficult. Doxycycline in addition to rifampin and streptomycin are the best-studied regimen which should be continued until CSF is clear. In the year following treatment, serum agglutinins fall to normal. The efficacy of corticosteroids is not proved. Neurobrucella has a better prognosis rather than other forms of chronic meningitis and the lesser of mortality; however, incidence of minor sequella [not limiting the normal life] is high. We presented one case of neurobrucellosis with presentation Acute toxic manifestations infection, include headache, neck ache, backache, insomnia, depression and muscle weakness several days before admission. The serologic study of both serum and CSF will usually reveal normal. But antibody against Brucella demonstrated in CSF by enzyme - linked immunosorbent assay [ELIS]. Doxycycline in addition to rifampin; ceftriaxon cotrimoxazol started for patient and patient cured. The diagnosis of neurobrucellosis require differentiation from other chronic meningitis, encephalitis, and granulomatous disease, most importantly tuberculosis and fungal infectious.early diagnosis and treatment are crucial factors leading to a good outcome: