Objective <p>To observe and analyse the clinical characteristics, diagnosis and treatment of <i>Human herpesvirus type 4</i> combined with <i>Brucella abortus</i> meningitis, in order to improve clinicians’ understanding of this disease.</p> Methods <p>The clinical data of a patient with<i>Human herpesvirus type 4</i> combined with <i>Brucella abortus</i> meningitis diagnosed on 8 January 2024 in Baotou People’s Hospital were analysed. Results The case was a middle-aged female patient with the main symptoms of dizziness and numbness and weakness of the limbs. The pathogenic microorganisms were detected as macrogenomic and copy number anomalies by double-homology: <i>Human herpesvirus type 4</i> was detected as sequence number 13, and the serum <i>Brucella abortus</i> tiger-red plate agglutination test was positive.</p> Results <p><i>Brucella</i> tube agglutination test: 1:400 ++. Symptoms improved significantly after treatment with doxycycline + rifampicin + cotrimoxazole tablets and prednisone acetate tablets.</p> Conclusion <p><i>Human herpesvirus type 4 (EBV)</i> combined with <i>Brucella abortus</i> meningitis is a rare infectious encephalitis with a poor prognosis and high recurrence rate. A step therapy strategy of antibiotics combined with glucocorticoids is currently recommended to control acute phase symptoms and reduce the risk of recurrence.</p>