Neurobrucellosis: report of a case with CVA manifestation

ABSTRACT

Although neurological symptoms in brucellosis are frequent, central nervous system [CNS] involvement is uncommon. A 42-year-old man was admitted with an episode of faint without loss of consciousness, right hemi paresis, diplopia and headache lasting for four days. The neurological examination revealed left hemi paresis. Limitation of gazing in left eye in lateral view was seen [partial paresis of 6[th] cranial nerve]. The results of laboratory examinations show positive Wright and Coombs Wright in blood and C.S.F. In the brain CT scan hydrocephaly and in magnetic resonance imaging [MRI] some brain atrophy, few high signal foci in the deep with mater had been detected. Treatment included concurrent administration of three drugs doxycycline, rifampicin and co-trimoxazole. This patient fully recovered. We suggest that Neurobrucellosis [NB] should always be sought in young patients with ischemic stroke, especially if they do not have any additional risk factors for stroke and live in an endemic area for brucellosis, even if they do not have other systemic signs of brucellosis