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Published on: May 23, 2021
A Rare Case of Neuralgic Amyotrophy Associated with Brucella Infection
Gaozan Zhang1, Fenfen Yan1, Fei He1
1Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, 130031, People's Republic of China.
Abstract:
Multiple micro-organisms associated with Neuralgic Amyotrophy (NA) have been reported and Brucella species should be an important and overlooked infectious cause or trigger.We report a rare case of neuralgic amyotrophy associated with Brucella infection and is believed to be the first such case report in China. A 42-year-old male with brucellosis was confirmed serologically, who presented recurrent fever and fatigue and suddenly developed severe pain in the right shoulder within one week, followed by the inability to lift and abduct the proximal end of the right upper limb. Based on typical clinical manifestions, MRI neuroimaging of the brachial plexus and neuro-electrophysiological studies to confirm a diagnosis of NA and presented spontaneous recovery during this period, immunomodulatory treatment with corticosteroid or intravenous immunoglobulin had not been attempted, leaving a serious movement disorder in the right upper limb. Even rare, NA and other neurobrucellosis forms should be considered as complications of Brucella infection.
Insights
Brucella infection can cause Neuralgic Amyotrophy (NA), a rare neurological condition. This case highlights Brucella as a potential trigger for NA, emphasizing its consideration in neurobrucellosis diagnoses.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Neuralgic Amyotrophy (NA) is a rare neurological disorder characterized by sudden, severe pain and muscle weakness, typically in the shoulder and arm.
- While various microorganisms have been linked to NA, Brucella species remain an under-recognized potential cause or trigger.
Observation:
- A 42-year-old male with serologically confirmed brucellosis presented with fever and fatigue, followed by acute right shoulder pain and upper limb dysfunction.
- Clinical manifestations, MRI neuroimaging of the brachial plexus, and neuro-electrophysiological studies confirmed a diagnosis of NA.
Findings:
- The patient experienced spontaneous recovery from NA symptoms despite no immunomodulatory treatment, though significant movement disorder persisted.
- This case is believed to be the first reported instance of NA associated with Brucella infection in China.
Implications:
- Brucella infection should be considered as a potential cause or trigger for Neuralgic Amyotrophy.
- This case underscores the importance of recognizing neurobrucellosis and its varied neurological complications, including NA.
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