Neurobrucellosis in Northern Iraq

Abstract

Neurobrucellosis is a rare neurological complication of brucellosis. This study describes 16 patients of neurobrucellosis which undoubtedly account for a small percentage of total admitted cases of brucellosis to Mosul city hospitals for tertiary care over a period of five years. The diagnosis was depended on history, clinical examination, positive brucella test, CSF examination and MRI or CT of the brain or spine. Headache, fever, sweating fatigue, drowsiness, neck stiffness, symptoms of cranial nerve involvement and backache were the common clinical features. Cerebrospinal fluid (CSF) showed an abnormal finding regarding increased cell count, elevated protein levels and low glucose in 9 patients and positive serology in 13 patients; while blood serology was highly reactive in all. The patients received a combination antibiotic therapy for 3 – 6 months. Patients with acute neurological complications as well as those with radiculoneuropathy responded favourably to treatment. The outcome was as follow: Eight patients recovered completely while other eight patients left with partial or complete disabilities. As neurobrucellosis is a fatal condition if remained untreated; doctors especially in endemic areas like Iraq should consider the likelihood of neurobrucellosis in patients with unexplained neurological and psychiatric symptoms.