Clinical and laboratory findings in neurobrucellosis: A study of 43 cases

Background: Brucellosis is a common zoonotic infection that is endemic in many parts of the world. Neurological involvement is a rare entity, occurs in 2-5% of cases. Neurobrucellosis comprises a variety of complications, including meningitis, meningoencephalitis, myelitis and myelopaties, peripheral and cranial neuropathies, and psychiatric manifestations. The aim of the present study was to evaluate neurological manifestations and cerebrospinal fluid (CSF) findings in a group of Iranian patients with neurobrucellosis. Materials and methods: During a 10-year period (1996-2005), medical records of 43 hospitalized patients with definite diagnosis of neurobrucellosis were studied. Inclusion criteria were a minimum titer of 1/160 for Wright and abnormal CSF findings. Age, gender, neurological manifestations, CSF analysis and its changes were investigated. Results: Neurological manifestations include meningitis (64.9%), meningoencephalitis (11.6%), cranial nerve palsy (11.6%), brain abscess (2.4%), myelitis (2.4%) and psychiatric disorders (6.9%). Pleocytosis (100%), high protein (40%) and low glucose levels (40%) were noted in CSF analysis. Conclusion: Clinical manifestations and CSF abnormality of neurobrucellosis is similar to tuberculosis and neurobrucellosis must be kept in mind in approach of patients with acute or chronic lymphocytic meningitis with increased protein and low glucose level in CSF and risk factors of brucellosis.