Neurobrucellosis presenting as acute stroke with brain abscesses: a case report

Abstract

Brucellosis is a prevalent zoonotic disease that is associated with consuming produce from animals infected with Brucella species, usually in the form of unpasteurized milk and milk products. The involvement of the central nervous system (CNS) is an uncommon but dangerous indication of neurobrucellosis. Neurobrucellosis can cause specific imaging findings on magnetic resonance imaging (MRI). In this study, we report a very rare case of neurobrucellosis presenting with stroke-like symptoms that were treated using antibiotics. A 38-year-old male was referred with a presenting complaint of headache, ataxia, and dysarthria. He was admitted one month prior for possible cerebral vascular accident (CVA), which was ruled out. On neurological examination, left-central facial paralysis and bilateral positive Babinski sign were observed. The brain magnetic resonance imaging (MRI) performed with and without contrast demonstrated an acute ischemic stroke in the right middle cerebral artery (MCA) territory and extra-axial heterogeneous ring-enhancing lesions, respectively. Brucellosis was confirmed on serological assessment. In rare instances, neurobrucellosis can cause stroke-like symptoms and brain abscesses. Neurobrucellosis should be considered in such patients when other neurological disorders cannot explain neuroimaging abnormalities.