Intracerebral nodular involvement in neurobrucellosis: case report and review of the literature.
- 1Department of Infectious Diseases and Clinical Microbiology, Kilis Prof. Dr. Alaeddin Yavaşça State Hospital, Kilis, Türkiye. [email protected].
- 2Department of Radiology, University of Health Sciences, Kayseri City Training and Research Hospital, Kayseri, Türkiye.
- 3Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kayseri City Training and Research Hospital, Kayseri, Türkiye.
Abstract
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.
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BibTeX
@article{kanat2026intracerebral,
title = {{Intracerebral nodular involvement in neurobrucellosis: case report and review of the literature.}},
author = {Azade Kanat and Bengi Cilasin and Kübra Güler and Havva Beyza Tağman and Ayşin Kılınç-Toker and Esma Eryılmaz-Eren and Üner Kayabaş},
journal = {BMC infectious diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14102-y},
url = {https://europepmc.org/article/MED/42968073},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Intracerebral nodular involvement in neurobrucellosis: case report and review of the literature.
AU - Azade Kanat
AU - Bengi Cilasin
AU - Kübra Güler
AU - Havva Beyza Tağman
AU - Ayşin Kılınç-Toker
AU - Esma Eryılmaz-Eren
AU - Üner Kayabaş
PY - 2026
DA - 2026/08/04
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14102-y
UR - https://europepmc.org/article/MED/42968073
AB - 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.
SN - 1471-2334
ER -