Bilateral papilledema caused by brucellosis mimicking pseudotumor cerebri

Abstract

In this article, we report a patient with migraine who was hospitalized with a prediagnosis of pseudotumor cerebri and diagnosed as neurobrucellosis with isolated intracranial hypertension presentation. A 22-year-old woman was admitted to emergency department with a complaint of headache. Her anamnesis indicated that she had migraine for 7 years. Neurological examination revealed bilateral papilledema. Cranial magnetic resonance imaging was normal. Cerebrospinal fluid (CSF) examination revealed 80 lymphocytes per mm3 with 178 mg/dL protein. Opening pressure was 260 mmH2O. Brucella tube agglutination and Rose Bengal tests were positive in blood and CSF. She was diagnosed as neurobrucellosis. If the systemic findings are insignificant and neurological findings are atypical such as isolated papillary edema, neurobrucellosis may not be considered and its diagnosis may be delayed. We believe that brucella serology should be included in the diagnostic protocols in endemic areas. Thus, early diagnosis and appropriate treatment can prevent complications of neurobrucellosis.