Ischemic Stroke as a Rare Manifestation of Neurobrucellosis: A Case Report

This article presents a case report of a patient with neurobrucellosis (NB) complicated by ischemic stroke (IS).

A male presented with new-onset left-sided limb weakness lasting three days, along with a 15-month history of intermittent fever and progressive right-sided limb weakness over eight months. A cranial MRI revealed an acute infarction in the left cerebellar vermis. Cerebrospinal fluid (CSF) analysis revealed elevated protein levels and pleocytosis. Next-generation sequencing (NGS) of the CSF detected 1469 Brucella species. Polymerase chain reaction (PCR) testing for the Brucella OMP22 gene was positive in the patient's urine, CSF, and blood samples. Following combination antimicrobial therapy with doxycycline, rifampicin, and trimethoprim-sulfamethoxazole (TMP-SMX), the patient's clinical symptoms progressively improved, and laboratory parameters normalized.

This case underscores the importance of considering NB in the differential diagnosis of patients presenting with unexplained symptoms in brucellosis-endemic regions. Early diagnosis and combined antibiotic therapy are critical to alleviating NB symptoms and improving clinical outcomes.