A rare pediatric case of neurobrucellosis with bilateral optic neuritis

Abstract

Background. The estimated incidence of central nervous system involvement in brucellosis ranges between 0 and 17.8%. Optic neuritis is infrequently seen in the clinical presentation of neurobrucellosis. Only six cases of neurobrucellosis manifesting with optic neuritis have been previously reported in the literature during childhood. Moreover, four of these were isolated optic neuritis. Case. An 11-year-old boy presented with the complaint of bilateral visual loss which was more prominent in the left eye than the right. He was diagnosed with brucellosis two months prior. His fundus examination revealed mild papilledema of the right eye and remarkable papilledema of the left eye. Brucella agglutination titer of serum was 1/640. Cerebrospinal fluid (CSF) cultures were negative, but polymerase chain reaction (PCR) examination in CSF was positive for Brucella melitensis. Antibiotic and pulse methylprednisolone treatments were administered. The visual acuity returned incompletely within the 12-month follow-up period. Conclusion. Isolated optic neuritis is a rare manifestation of neurobrucellosis in children.