Abstract Details

Title Neurobrucellosis Presenting with Parkinsonism and Psychiatric Manifestations: Two Cases from Saudi Arabia

Topic Infectious Disease

Presentation(s) P11 - Poster Session 11 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-001

Objective To describe two cases of neurobrucellosis presenting with Parkinsonism-like symptoms and psychiatric manifestations, highlighting the diagnostic challenges and therapeutic responses in a rare manifestation of this zoonotic infection.

Background Brucellosis, a zoonotic disease caused by Brucella species, remains endemic in regions such as Saudi Arabia. While neurobrucellosis is a serious complication, its presentation with parkinsonian features and psychiatric manifestations is exceedingly rare, with only six such cases reported in the literature. These case reports add to the limited data on atypical presentations of neurobrucellosis.

Design/Methods

We report two male patients from Saudi Arabia, aged 75 and 26, diagnosed with neurobrucellosis based on high Brucella titers and cerebrospinal fluid polymerase chain reaction (CSF PCR) results. Both patients presented with Parkinsonism-like symptoms, including tremors, rigidity, and bradykinesia, alongside significant psychiatric disturbances such as hallucinations and cognitive impairment. Brain magnetic resonance imaging (MRI) in both cases revealed abnormalities consistent with meningoencephalitis. Both patients received a combination of antibiotics (doxycycline, rifampicin, and sulfamethoxazole-trimethoprim) and corticosteroids to manage inflammation.

Results Prolonged antibiotic therapy led to significant clinical improvement in both patients, with marked reduction in both neurological and psychiatric symptoms. Despite improvement, residual Parkinsonism-like symptoms persisted, necessitating extended therapy and long-term follow-up.

Conclusions These cases emphasize the importance of considering neurobrucellosis in patients from endemic regions with atypical neurological and psychiatric symptoms. Early diagnosis through serological and molecular testing, followed by prompt and prolonged antibiotic therapy, is crucial for favorable outcomes.

Authors/Disclosures
Moneera Aldraihem, MBBS (King Fahad Medical City) PRESENTER	Dr. Aldraihem has nothing to disclose.
Mohammed A. AlShareet, MBBS (King Fahad medical city-Riyadh-saudi Arabia)	Dr. AlShareet has nothing to disclose.
Thamer S. Alhowaish, MD (King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia)	Dr. Alhowaish has nothing to disclose.
Thamer S. Alhowaish, MD (King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia)	Dr. Alhowaish has nothing to disclose.
Mazen S. Alamr, MBBS (Mayo Clinic)	Dr. Alamr has nothing to disclose.
Omar A. Alsinaidi, MD (Case Western Reserve University)	Dr. Alsinaidi has nothing to disclose.
Abdulrahman Ali	No disclosure on file
Hisham Aldhukair, MBBS (King Fahd Medical City, Neurology department)	Dr. Aldhukair has nothing to disclose.

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