Abstract
Background: Neurobrucellosis is a rare complication of brucellosis. Acute meningitis and encephalitis are the most common clinical manifestations; however, symptoms of these two conditions may be subacute and diagnosis requires a high index of suspicion in patients from endemic areas. Diagnosis is often based on neurological symptoms, serology, and suggestive brain imaging because cerebrospinal fluid culture yields are low.
 Case report: Herein we report a 30 year old  female a known case of MS (Multiple Sclerosis) who presented  with ataxia and agitation, in physical examination the patient had ataxic gait and decreased concentration, Brain MRI showed significant brain atrophy and hydrocephaly. Laboratory workups showed a lymph dominant leukocytosis. ESR and CRP rose significantly. CSF (Cerebrospinal fluid) was obtained and sent for cell count and chemistry analysis. The CSF analysis showed 1734 mg/dl protein, 254 leukocytes (80% lymphocyte). Complete blood count (CBC) showed lymph dominant leukocytosis. Wright test in CSF was positive. Accordingly Neurobrucellosis was considered as the cause.
 Conclusion: Due to several of immunomodulating or immunosuppressive treatments in the patients with MS, and Chronic suppression of cell-mediated immunity these patients may be more prone to infections. So in such patients careful evaluation of clinical findings are of great importance.
Highlights
Neurobrucellosisin in A Patient with Multiple SclerosisClinical presentations of neurobrucellosis are non-specific and subacute
Brucellosis is an endemic zoonotic disease; it is common in certain parts of the world such as Middle East or South America
Brucella Infection triggers the immune mechanism leading to a demyelinating state in central nervous system (CNS)
Summary
Clinical presentations of neurobrucellosis are non-specific and subacute. The signs and symptoms of central nervous system (CNS) involvement are very vague. Neck stiffness occurs in less than one half of patients with meningitis. Chronic meningoencephalitis is the most common clinical presentation, Myelitis, radiculoneuritis, brain and epidural abscess, and meningovascular syndromes are seen in some cases [3]. We report a 30 years old female, a known case of Multiple Sclerosis (MS) who came with ataxia and lower extremities hypoesthesia. Following physical examination and paraclinical evaluations Neurobrucellosis was detected
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
