Abstract
Neurobrucellosis is a focal form of brucellosis that may be
life-threatening if not timely diagnosed and treated. Pseudotumor
cerebri (PTC) has rarely been reported as the sole manifestation of
brucellosis. A 41-year-old woman came to the hospital with chronic
headaches, vertigo, and nausea. She had been experiencing symptoms for 8
months, starting with blurred vision and headache. The diagnosis was
pseudotumor cerebri, managed with acetazolamide and topiramate. She had
bilateral papilledema but a normal chest and cranial nerves exam. Lab
tests were normal except for high ESR. Brain scans showed no issues. A
lumbar puncture was done to reduce intracranial pressure. High ICP made
CSF shunt necessary to prevent visual loss. However, a serum brucella
agglutination test was done due to chronic neurological symptoms and
lymphocyte dominance in CSF analysis. A positive result with the Wright
test and 2ME titer. After two weeks, the patient was treated with
gentamycin, ceftriaxone, doxycycline, and rifampin, and improved without
neurosurgical intervention. Here, we have reported a case of brucellosis
with severe headaches, progressive visual impairment, and fundoscopic
finding of papilledema, later diagnosed as brucellosis-induced PTC.
Keywords: Neurobrucellosis; Pseudotumor Cerebri; Intracranial
pressure