Acute Brucellosis with a Guillain-Barre Syndrome-Like Presentation: A Case Report and Literature Review

Alanazi, Ali; Najjar, Sara Al; Madkhali, Jnadi M.; Malik, Yaser Al; Al-Khalaf, Athal; Alharbi, Ahmad

doi:10.3390/idr13010001

Cited by 10 publications

(13 citation statements)

References 26 publications

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“…Brucellosis is a disease that can affect the central and peripheral nervous system, and it has variable neurological manifestations. However, brucellosis infection that presents with acute peripheral neuropathy mimicking GBS-like manifestations was reported among 19 cases according to Alanazi et al [ 15 ] Although our patient had confirmed signs of peripheral neuropathy, his presentation lacks any signs of meningitis, encephalitis, brain abscess, myelitis, or radiculitis, commonly seen in neurobrucellosis. It is recommended to investigate for Brucella among patients in endemic regions presenting with acute peripheral neuropathy [ 15 ].…”

Section: Discussionmentioning

confidence: 59%

“…However, brucellosis infection that presents with acute peripheral neuropathy mimicking GBS-like manifestations was reported among 19 cases according to Alanazi et al [ 15 ] Although our patient had confirmed signs of peripheral neuropathy, his presentation lacks any signs of meningitis, encephalitis, brain abscess, myelitis, or radiculitis, commonly seen in neurobrucellosis. It is recommended to investigate for Brucella among patients in endemic regions presenting with acute peripheral neuropathy [ 15 ]. On the other hand, peripheral neuropathy is a frequent finding in AAV and may occur in up to 70% of patients with microscopic polyangiitis and 15% of patients with granulomatosis and polyangiitis [ 16 ].…”

Section: Discussionmentioning

confidence: 59%

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P-ANCA Systemic Vasculitis Induced by Brucellosis in an Elderly Male Patient

Cheikh

Kabli

Sendi

et al. 2021

Case Reports in Rheumatology

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One of the most prevalent causes of vasculitis is bacterial infection. An infection that causes anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is uncommon and not reported frequently. We report a case of a 74-year-old male who presented with fever for ten days and was found to have brucellosis. Then, he was diagnosed with Guillain-Barré syndrome (GBS) and started on immunoglobulin (IVIG) for one week without a response. His fever was still persistent despite appropriate antibiotic therapy. Rheumatology evaluation revealed a history of multiple joint pain and swelling, elevated inflammatory marker, and a high titer of P-ANCA. Steroid therapy was started initially on the background of antibiotics therapy. His fever and other symptoms showed marked improvement after one week. However, P-ANCA titer was still elevated. The decision was made to treat the patient as a case of brucellosis-induced P-ANCA vasculitis. Azathioprine was added, and steroid was maintained for one month and then it was tapered gradually. All symptoms improved from the third month of follow-up except weakness from peripheral neuropathy with normalization of P-ANCA titer. His condition remained stable after six months of follow-up. Clinicians should be aware of the possibility of infection-induced vasculitis, particularly when patients’ symptoms persist despite the appropriate use of antibiotics.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 59%

P-ANCA Systemic Vasculitis Induced by Brucellosis in an Elderly Male Patient

Cheikh

Kabli

Sendi

et al. 2021

Case Reports in Rheumatology

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“…Peripheral nervous system involvement occurs in 7% of neurobrucellosis cases 21 . Acute, subacute, or chronic polyradiculoneuropathies, some without sensory involvement or mimicking Guillain-Barré syndrome, have been described in case reports 21 , 22 .…”

Section: Neurological Manifestationsmentioning

confidence: 99%

Neurobrucellosis: the great mimicker

Soares

Angelim

Brandão³

et al. 2022

Rev. Soc. Bras. Med. Trop.

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Neurobrucellosis is caused by bacteria of the genus Brucella and is responsible for several clinical manifestations, making diagnosis challenging. The most common route of infection is through the consumption of unpasteurized or raw dairy products such as fresh milk, butter, and cheese. As neurological complications can develop chronically, they are frequently misdiagnosed as other infections, such as tuberculosis. This report reviews the clinical manifestations, diagnostic approach, treatment, and prognosis of neurobrucellosis, illustrating a case of chronic intracranial hypertension and meningoencephalitis secondary to brucellosis. The clinical presentation of brucellosis can mimic several systemic diseases, resulting in diagnostic delays and clinical complications. A high degree of suspicion is required, and neurobrucellosis should always be considered in the differential diagnosis of chronic meningitis.

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“…One patient (5.3%) died, and 16 patients (84.2%) recovered their walking ability. Walking recovery time varied from two weeks to one year [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

A case of brucellosis-induced Guillain–Barre syndrome

Liu

Jiang

et al. 2022

BMC Infect Dis

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Background Guillain–Barre syndrome (GBS) is a rare neurological complication of brucellosis, and neurobrucellosis is the most common, but they have many similarities in clinical manifestations. Many clinicians are accustomed to merely explaining the manifestations of nervous system involvement with neurobrucellosis, but they ignore the possibility of GBS, and this leads to misdiagnosis, untimely treatment, and serious consequences. Case presentation A 55-year-old male patient was admitted to The First Affiliated Hospital of Harbin Medical University for intermittent fever, fatigue, and waist pain more than three months. Brucellosis was diagnosed from the blood test. Although anti-brucella treatment was given at the time of diagnosis, the disease continued to progress. At the time of the cerebrospinal fluid systematic physical examination and the neuroelectrophysiological test, acute motor sensory axonal neuropathy was diagnosed. The patient was given immediately administered immunoglobulin therapy. After three months of systemic treatment, the patient's muscle strength of the distal limbs gradually recovered. The numbness of the limbs eased slowly, and urination function and respiratory function returned to normal. He could sit by himself. Conclusions The possibility of GBS should be closely monitored for when a brucellosis patient shows typical clinical manifestations of progressive muscle weakness, protein-cell separation of the cerebral spinal fluid, and typical demyelinating sensorimotor polyneuropathy.

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Acute Brucellosis with a Guillain-Barre Syndrome-Like Presentation: A Case Report and Literature Review

Cited by 10 publications

References 26 publications

P-ANCA Systemic Vasculitis Induced by Brucellosis in an Elderly Male Patient

P-ANCA Systemic Vasculitis Induced by Brucellosis in an Elderly Male Patient

Neurobrucellosis: the great mimicker

A case of brucellosis-induced Guillain–Barre syndrome

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