Neurobrucellosis with ischemic stroke and spinal cord involvement: a case report

Hongfeng Wen,Tao Wu,Di Jin,Haichao Liu,Lina Cai

doi:10.1186/s12883-021-02155-2

Hongfeng Wen, Tao Wu + Show 3 more

Open Access

https://doi.org/10.1186/s12883-021-02155-2

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Journal: BMC Neurology	Publication Date: Mar 20, 2021
Citations: 2	License type: open-access

Affiliation: Aerospace Center Hospital

Abstract

BackgroundBrucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Ischemic stroke is a rare clinical symptom, but if it is not diagnosed and treated early, it may cause more severe consequences.Case presentationWe report a 38-year-old man presenting with hearing impairment for four years and sudden weakness of the right limb for two years, recurrent aphasia, and gradual weakness of bilateral lower limbs for nine months. He had bilateral positive Babinski’s sign. Cerebrospinal fluid (CSF) showed raised protein and pleocytosis. Magnetic resonance imaging (MRI) showed ischemic infarcts in the pons and extensive enhancement of spinal meninges combined with spinal cord atrophy and ischemia. The tests revealed Brucella Rose Bengal positive in serum and CSF. Brucella culture in CSF was also positive. Next-generation sequencing (NGS) of CSF revealed positive for Brucella with 105 species were detected. He showed significant improvement with antibiotics at five months follow-up.ConclusionsNeurobrucellosis may mimic stroke and transverse myelitis like syndromes. NB is a treatable infectious condition and should always be considered in the differentials, especially if there are risk factors, as in our case.

Highlights

Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system
We report a case of neurobrucellosis (NB) mimicking stroke and transverse myelitis
This case was diagnosed by Next-generation sequencing (NGS) of the Cerebrospinal fluid (CSF) and subsequently confirmed by Brucella cultured from CSF

Summary

Introduction

Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Background Brucellosis is a common zoonotic disease, usually caused by infections of different Brucella species. Brucellosis infection of the central nervous system (CNS) is a rare but severe complication [2, 3] and the varied clinical manifestations, including confusion, meningoencephalitis, myelitis, peripheral or cranial neuropathies, and psychiatric manifestations, make the diagnosis challenging. We report a case of neurobrucellosis (NB) mimicking stroke and transverse myelitis.

Results

Conclusion