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Brucellosis and polyneuroradiculomyeloencephalitis. A case report

R Riestra-Castañeda1, A González-Garrido, S González-Cornejo

  • 1Departamento de Neurología y Neurocirugía, Laboratorio de Microcirugía y Cirugía y de Base de Cráneo, Hospital Civil de Guadalajara, Guadalajara, Jal., México.

Archives of Medical Research
|January 1, 1996
PubMed
Summary

This case report details a rare instance of brucellosis affecting both the central and peripheral nervous systems in a young woman. Successful treatment with doxycycline and rifampin prevented relapse, highlighting effective management strategies for neurobrucellosis.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Brucellosis is a zoonotic infection with diverse clinical manifestations.
  • Neurological involvement in brucellosis is uncommon, with simultaneous central and peripheral nervous system (CNS/PNS) compromise being exceptionally rare.
  • Consumption of unpasteurized dairy products is a common risk factor.

Observation:

  • A young female patient presented with symptoms suggestive of neurobrucellosis.
  • Clinical and laboratory findings confirmed active brucellosis with nervous system impairment.
  • Cerebrospinal fluid (CSF) analyses were initially negative.

Findings:

  • Electrophysiological studies and sural nerve biopsy provided crucial diagnostic evidence.
  • The patient was diagnosed with polyneuroradiculomyeloencephalitis secondary to brucellosis.

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  • Histopathological examination of the sural nerve biopsy revealed inflammatory changes consistent with the diagnosis.

    • Implications:

    • This case underscores the importance of considering brucellosis in the differential diagnosis of unexplained polyneuroradiculomyeloencephalitis, especially in endemic areas or with relevant exposure history.
    • Early diagnosis and appropriate antibiotic therapy (doxycycline and rifampin) are critical for successful outcomes and preventing long-term neurological sequelae.
    • The findings contribute to the limited literature on simultaneous CNS and PNS involvement in brucellosis, aiding in understanding its complex neuropathogenesis.