Infect Chemother.  2015 Dec;47(4):268-271. 10.3947/ic.2015.47.4.268.

Relapsed Brucellosis Presenting as Neurobrucellosis with Cerebral Vasculitis in a Patient Previously Diagnosed with Brucellar Spondylitis: A Case Report

• Kim EJ
• Lee SJ
• Ahn EY
• Ryu DG
• Choi YH
• Kim TH

• KMID: 2170506
• DOI: http://doi.org/10.3947/ic.2015.47.4.268

Abstract

Brucellosis is a multisystem disease with various clinical symptoms. Neurobrucellosis is a rare but serious manifestation of brucellosis. A 60-year-old man with a previous diagnosis of brucellar spondylitis presented with sudden onset of aphasia and numbness of the right upper extremity. Cerebral angiography showed diffuse narrowing and dilatation on the distal branches of both the anterior cerebral artery (ACA) and the left middle cerebral artery (MCA) which indicated cerebral vasculitis, and the patient's Brucella agglutinin titer was 1:1280. After combined antimicrobial and steroid therapy was started, the patient's condition improved significantly, and he was discharged after 1 month. Antimicrobial therapy was continued for 16 months on an outpatient basis, and the last Brucella agglutinin titer was 1:40. To our knowledge, this is the first case of relapsed neurobrucellosis with vasculitis in Korea to have been treated successfully.

Keyword

Brucellosis; Neurobrucellosis; Cerebral vasculitis

MeSH Terms

Anterior Cerebral Artery
Aphasia
Brucella
Brucellosis*
Cerebral Angiography
Diagnosis
Dilatation
Humans
Hypesthesia
Korea
Middle Aged
Middle Cerebral Artery
Outpatients
Spondylitis*
Upper Extremity
Vasculitis
Vasculitis, Central Nervous System*

Figure

• 

  Figure 1 (A) MRI (B) Cerebral angiography. Scans demonstrate occlusion of branches of the left MCA, multiple vascular cutoff signs, vascular contour irregularities, and stenosis (arrows). MCA, middle cerebral artery.

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