Unusual presentation of neurobrucellosis in Jeddah, Kingdom of Saudi Arabia

Abstract

A 35-year-old female without any history of medical or psychiatric illness. One month prior to presenting to our clinic, she had intermittent headaches, night sweats, and muscle pain that went unnoticed by her. A week later, the patient developed agitation and behavioral changes. The patient was admitted through emergency room (ER) to the psychiatry unit for 3 days. During a detailed interview in the Neurology Clinic 10 days post discharge, she described the previously mentioned symptoms. Her cerebrospinal fluid analysis revealed leukocytosis, with normal protein and glucose, and positive brucella titers in blood. She received antibiotics for neurobrucellosis with frequent follow ups. Repeated spinal tap was reported normal. Her symptoms gradually improved. Neuropsychiatric manifestations are an unusual presentation of brucellosis. This case emphasizes the importance of considering an organic cause, such as neurobrucellosis, as a differential diagnosis in patients with new onset of unexplained neuropsychiatric symptoms in endemic countries like Kingdom of Saudi Arabia.