A Case of Neurobrucellosis Mimicking Guillain-Barre Syndrome

BACKGROUND:
Brucellosis is an infectious disease due to Gram negative bacteria of genus brucella. Involvement of different systems including gastrointestinal tract, the hepatobilliary and skeletal systems has been frequently reported. Involvement of nervous system is not common, and its incidence has been reported to be 3-25% of the cases of generalized brucellosis. In this study, we report a case of Guillain-barre syndrome as an infrequent presentation of neurobrucellosis.

METHODS:
A 28-year-old man is reported, who was referred because of acute progressive flaccid paraplegia, ataxia and areflexia. Electrophysiological and cerebrospinal fluid study was identical to Guillain- barre syndrome. Anti- brucella antibody (ELISA) in cerebrospinal fluid, and serum Wright and 2ME tests were positive.

FINDINGS:
The patient underwent plasmaphresis for 7 times with 1.5 lit of plasma per day, but without favorite clinical response. By identification of neurobrucellosis, antimicrobial therapy with Doxycycline, Rifampin and Co-trimoxazole was started. He showed considerable recovery 3 months latter.

CONCLUSION:
Brucellosis is considered as a new etiologic agent for Guillain – barre syndrome. In endemic region, neurobrucellosis must be considered in any patient with Guillain- barre syndrome.

KEY WORDS:
Guillain-Barre syndrome, Neurobrucellosis, Polyradiculoneuropathy