2024, Volume 17, Issue 8, pp 819 – 822

Pediatric neurobrucellosis and atypical Guillain-Barré syndrome: an intriguing case unveiled

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Authors and Affiliations

Corresponding author Huda Zaher Internal Medicine Department, Neurology Division, King Fahad General Hospital, Jeddah, Saudi Arabia E-mail: hudazaher@hotmail.com

Abstract

Brucellosis, a chronic zoonotic disease with a significant global burden, particularly in endemic areas, can also present as neurobrucellosis, a rare complication. We report a case of polyradiculoneuropathy in a pediatric patient resulting from this uncommon presentation. A 5-year-old girl presented with progressive asymmetric lower limb weakness for two weeks that progressed to a loss of ambulation in four weeks. She also had flu-like symptoms and persistent high-grade fever. Her history was notable for ingesting raw milk before the onset of fever. Initial examination revealed meningismus signs and fever. She had bilateral weak hip flexion graded 4/5 on the Medical Research Council (MRC) scale, weak right and left knee flexion (3/5 and 4/5, respectively), and weak right ankle dorsiflexion (4/5). She also had diminished reflexes throughout. The patient exhibited a clinical picture resembling Guillain-Barré Syndrome (GBS) after admission as her weakness progressed. Cerebrospinal fluid (CSF) analysis revealed no cell counts, elevated protein levels (1545 mg/dL), and normal glucose levels (3.34 mmol/L). Blood and CSF cultures were negative, but the serum antibody titer was elevated at 1:1280 against Brucella melitensis and Brucella abortus species. Lumbosacral MRI showed diffuse enhancement of the lower nerve roots. A nerve conduction study (NCS) demonstrated axonal and demyelinating polyradiculoneuropathy. The patient regained her strength three months after presentation, following a course of antibiotics. When evaluating patients with atypical manifestations resembling GBS, brucellosis should be considered an important differential diagnosis in endemic areas.

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About this article

PMC ID: 11556518
PubMed ID: 
DOI: 10.25122/jml-2023-0522

Article Publishing Date (print): 8 2024
Available Online: 

Journal information

ISSN Printing: 1844-122X
ISSN Online: 1844-3117
Journal Title: Journal of Medicine and Life

Copyright License: Open Access

This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.


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