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Abducens nerve palsy and optic neuritis as initial manifestation in brucellosis

Basak Karakurum Goksel1, Deniz Yerdelen, Mehmet Karatas

  • 1Department of Neurology, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Centre, Adana, Turkey. bkarakurum@hotmail.com

Scandinavian Journal of Infectious Diseases
|July 22, 2006
PubMed

Insights

Brucellosis rarely affects cranial nerves. Early antibiotic treatment for this infection, presenting as optic neuritis and abducens nerve palsy, led to significant patient recovery.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Brucellosis is a zoonotic infection with diverse clinical manifestations.
  • Cranial nerve involvement in brucellosis is uncommon, posing diagnostic challenges.

Observation:

  • A case of brucellosis presented with left-sided optic neuritis and abducens nerve palsy.
  • Cerebrospinal fluid analysis revealed Brucella meningitis with elevated protein, low glucose, and pleocytosis.
  • Positive Brucella agglutination tests in both cerebrospinal fluid (1/128) and serum (1/1280) confirmed the diagnosis.

Findings:

  • The patient received a combination therapy of intravenous ceftriaxone, oral rifampicin, and oral doxycycline.
  • Two months post-treatment, significant improvement in left-eye visual acuity and near-complete resolution of left abducens palsy were observed.

Implications:

  • This case highlights that cranial nerve brucellosis, though rare, can have a favorable prognosis.
  • Prompt initiation of appropriate anti-Brucella therapy is crucial for favorable neurological outcomes in affected patients.

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