Neurobrucellosis Presenting as Pyrexia of Unknown Origin and Meningoencephalitis: A Rare and Challenging Case.

Background-

Neurobrucellosis is a rare and potentially life-threatening complication of brucellosis, a zoonotic infection caused by Brucella species. It can present with a wide range of neurological symptoms, making diagnosis challenging.

Case Presentation-

We report a rare and challenging case of neurobrucellosis presenting as pyrexia of unknown origin (PUO) and meningoencephalitis in a 45-year-old male. The patient presented with a 2-month history of fever, headache, and confusion. Extensive investigations, including blood cultures, imaging studies, and serological tests, were inconclusive. Brucella serology was eventually performed, revealing high titers of anti-Brucella antibodies.

Diagnosis and Treatment-

The patient was diagnosed with neurobrucellosis and treated with a combination of antibiotics, including doxycycline, rifampicin, and streptomycin. He showed significant clinical improvement, with resolution of fever, headache, and confusion.

Discussion-

This case highlights the importance of considering neurobrucellosis in the differential diagnosis of PUO and meningoencephalitis, particularly in patients with a history of exposure to animals or consumption of unpasteurized dairy products. Early diagnosis and treatment are crucial to prevent long-term neurological sequelae and improve outcomes. A thorough medical history, physical examination, and diagnostic workup are essential for early detection and treatment of this potentially life-threatening condition.

Conclusion-

Neurobrucellosis is a rare and challenging diagnosis that requires a high index of suspicion. This case report emphasizes the importance of considering neurobrucellosis in the differential diagnosis of PUO and meningoencephalitis, and highlights the need for prompt treatment to improve outcomes. Clinicians should be aware of the clinical manifestations and diagnostic challenges of neurobrucellosis to ensure timely and effective management.