A Case Report on Neurobrucellosis: A forgotten Cause of Meningoencephalitis:

Apoorva Dhiman; Kanika Khamb; Sanjay K. Mahajan

Apoorva Dhiman Junior Resident, Department of Internal Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
Kanika Khamb Junior Resident, Department of Internal Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
Sanjay K. Mahajan Professor, Department of Internal Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Abstract

Abstract

Human brucellosis caused by Brucella melitensis is the most prevalent zoonotic infection globally. This report highlights a case of neurobrucellosis in a male patient from rural India, underscoring the importance of timely clinical suspicion followed by microbiological confirmation. A 64-year-old farmer from Himachal Pradesh, India, presented to us with a short history of fever, moderate diffuse headache, and myalgia. He subsequently developed sudden-onset left hemiparesis, disorientation, bilateral sensorineural hearing loss, and neck rigidity. Laboratory investigations revealed abnormal blood counts, and cerebrospinal fluid analysis showed increased lymphocytes and protein content. Serological tests confirmed the diagnosis of neurobrucellosis. Prompt initiation of antibiotic therapy resulted in significant clinical improvement. This case highlights neurobrucellosis as a rare but a significant manifestation. It is important to consider it as a differential in a patient of atypical meningoencephalitis. A very specific history of contact with livestock or unpasteurised dairy is also imperative. The patient’s swift response to targeted antibiotic therapy underscores the value of timely diagnosis and effective management in improving outcomes.

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