An Uncommon Case of Pediatric Neurobrucellosis Associated with Intracranial Hypertension

Abstract

We present the case of a 4-year-old boy who was admitted to hospital with intracranial hypertension, headache, diplopia, papilledema, and a normal brain MRI. Brucella melitensis in the cerebrospinal fluid was confirmed with PCR assay. We believe that neurobrucellosis should be included in the differential diagnosis when headaches persist following brucellosis. In addition, we suggest that when cerebrospinal fluid culture is negative, PCR may prove to be an optimal alternative tool for an immediate and accurate diagnosis.

Prehypertension among young adult females in Dammam, Saudi Arabia

“…We agree with the comments of Professor Al-Mendalawi regarding the absence of the classical diagnostic findings of neurobrucellosis in the studied patient. However, it has been reported that there are many discrepancies in the diagnostic criteria of neurobrucellosis [11]. We think that this is especially true for paediatric neurobrucellosis.…”

“…Unusual presentations of paediatric neurobrucellosis have been reported including Guillain-Barré syndrome [8,9], epileptic seizures and aggressive mood, intracranial hypertension [10][11][12], acute onset of bilateral blindness [13], visual impairment and unilateral hearing loss [14].…”

A rare pediatric case of neurobrucellosis with bilateral optic neuritis

“…Such patients also may come to remedy with similar symptoms and findings of optic neuritis. 19,20 Therefore, to determine CSF, pressure by lumbar puncture is the rule for definitive diagnosis. Also, LHON should be kept in mind in a patient with vision loss.…”

Bilateral Papilledema Caused by Brucellosis Mimicking Pseudotumor Cerebri

“…[11,12] Lymphocytic pleocytosis, decreased glucose level, and elevated protein content are seen in the CSF. [9,10,13] Presumptive diagnosis can be made serologically by Rose Bengal and standard tube agglutination tests. [6] Papilledema occurs in 3% of cases of neurobrucellosis.…”