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Background <p>Brucellosis is a systemic disease with a wide range of clinical presentations that can mimic many infectious and non-infectious diseases. Neurobrucellosis (NB) is a significant clinical entity of brucellosis that can lead to serious neurological sequelae if appropriate treatment is not initiated after an early diagnosis. The clinical course of the disease is relatively insidious, and although it is frequently subacute or chronic, it can present with acute manifestations. We report the case of a 31-year-old male patient who presented to the emergency department with neurological symptoms and was found to have an intracerebral nodular lesion, a rare manifestation of NB.</p> Case presentation <p>A 31-year-old male livestock worker presented to the emergency department with complaints of headache, dizziness, and impaired consciousness lasting for two days, following 20 days of night sweats and musculoskeletal pain. Initial cerebrospinal fluid (CSF) analysis revealed pleocytosis, increased protein levels, and decreased glucose levels. Cranial magnetic resonance imaging (MRI) revealed leptomeningeal enhancement and nodular lesions measuring millimeters in size, with contrast enhancement in the right temporal lobe. Although the initial cultures were negative, a positive serum Brucella tube agglutination test at a 1/5120 titer, CSF analysis, and radiological findings showing neurological involvement confirmed the diagnosis of NB. The patient was treated with a triple-antibiotic regimen consisting of ceftriaxone, doxycycline, and rifampicin. This intervention resulted in complete clinical recovery and radiological resolution of the intracerebral lesions during the follow-up.</p> Results <p>This case highlights the importance of including NB in the differential diagnosis of intracerebral nodular lesions, particularly in endemic regions. This case suggests that NB, although rare, may present with intracerebral lesions that can regress with appropriate antimicrobial therapy. An integrated clinical, serological, and radiological evaluation may aid timely diagnosis, and when a rapid response to antibiotic treatment is observed, it may help reduce the need for invasive diagnostic procedures, such as brain biopsy, in selected cases.</p> Clinical trial number <p>Not applicable.</p>

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Intracerebral nodular involvement in neurobrucellosis: case report and review of the literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Azade Kanat,
  • Bengi Cilasin,
  • Kübra Güler,
  • Havva Beyza Tağman,
  • Ayşin Kılınç-Toker,
  • Esma Eryılmaz-Eren,
  • Üner Kayabaş

摘要

Background

Brucellosis is a systemic disease with a wide range of clinical presentations that can mimic many infectious and non-infectious diseases. Neurobrucellosis (NB) is a significant clinical entity of brucellosis that can lead to serious neurological sequelae if appropriate treatment is not initiated after an early diagnosis. The clinical course of the disease is relatively insidious, and although it is frequently subacute or chronic, it can present with acute manifestations. We report the case of a 31-year-old male patient who presented to the emergency department with neurological symptoms and was found to have an intracerebral nodular lesion, a rare manifestation of NB.

Case presentation

A 31-year-old male livestock worker presented to the emergency department with complaints of headache, dizziness, and impaired consciousness lasting for two days, following 20 days of night sweats and musculoskeletal pain. Initial cerebrospinal fluid (CSF) analysis revealed pleocytosis, increased protein levels, and decreased glucose levels. Cranial magnetic resonance imaging (MRI) revealed leptomeningeal enhancement and nodular lesions measuring millimeters in size, with contrast enhancement in the right temporal lobe. Although the initial cultures were negative, a positive serum Brucella tube agglutination test at a 1/5120 titer, CSF analysis, and radiological findings showing neurological involvement confirmed the diagnosis of NB. The patient was treated with a triple-antibiotic regimen consisting of ceftriaxone, doxycycline, and rifampicin. This intervention resulted in complete clinical recovery and radiological resolution of the intracerebral lesions during the follow-up.

Results

This case highlights the importance of including NB in the differential diagnosis of intracerebral nodular lesions, particularly in endemic regions. This case suggests that NB, although rare, may present with intracerebral lesions that can regress with appropriate antimicrobial therapy. An integrated clinical, serological, and radiological evaluation may aid timely diagnosis, and when a rapid response to antibiotic treatment is observed, it may help reduce the need for invasive diagnostic procedures, such as brain biopsy, in selected cases.

Clinical trial number

Not applicable.