Neurobrucellosis presenting as stroke: a case report from Qatar

Brucellosis is a zoonotic disease that is endemic to the Arabian Peninsula and is found to affect many organs of the human body. Neurological manifestations with brucellosis were reported in 25% of cases. However, most cases suggested the involvement of the central nervous system (CNS) by invasion through the blood-brain barrier. Here, we report a 45-year old male patient who presented with sudden onset right upper and lower limb weakness, similar to the presentation of an ischemic cerebrovascular accident (CVA), associated with constitutional symptoms of fever and low back pain. The patient had no signs to suggest cranial nerve or cord involvement. Further analysis showed that his blood and serum samples were positive for Brucella spp. He was treated with intravenous ceftriaxone for seven days, followed by oral doxycycline and rifampicin for three months. He was asymptomatic at follow-up after three months. Neurobrucellosis can present with stroke-like symptoms, and in endemic areas, prompt testing of brucella serology is warranted in patients presenting as stroke with systemic symptoms.