Atypical Neurological Presentation in Section Brucellosis: A Rare Case Report

Neurobrucellosis is an atypical and grave complication of brucellosis. It can present with a wide range of neurological symptoms, often mimicking other Central Nervous System (CNS) disorders, making diagnosis challenging. The present case report describes neurobrucellosis in a 47-year-old male who presented with atypical neurological symptoms, including depressed mood, dysarthric speech, increased sleepiness for 15 days, and altered sensorium for two days. Initial investigations, including routine Cerebrospinal Fluid (CSF) analysis, were non-contributory, and neuroimaging suggested acute encephalopathy with acute lacunar infarct. However, a high index of clinical suspicion due to his occupation as a farmer with cattle exposure led to advanced serological testing, which showed positive Brucella Immunoglobulin M (IgM), confirming Brucella infection. The patient was diagnosed with neurobrucellosis and responded favourably to a prolonged course of combination antibiotic therapy. This case underscores the need to include neurobrucellosis in the differential diagnosis of unexplained neurological symptoms, particularly in endemic areas or when there is a history of potential, even minimal, exposure.