Abstract
Background
Brucellosis, while primarily known for its systemic manifestations, can occasionally involve the central nervous system, resulting in meningoencephalitis. This report presents an atypical case of Brucella meningoencephalitis, marked by co-infection with Epstein-Barr virus and the development of bilateral optic neuritis, which was further complicated by drug-induced hepatitis against a background of resolved pulmonary tuberculosis.
Case Presentation
We report a unique case of Brucella meningoencephalitis in a 34-year-old male with concurrent Epstein-Barr virus infection and bilateral optic neuritis that was further complicated by drug-induced hepatitis and a history of pulmonary tuberculosis. The diagnosis was confirmed through cerebrospinal fluid metagenomic next-generation sequencing and MRI findings. Treatment was challenging, requiring a multidisciplinary approach due to concurrent hepatic and infectious disease considerations, and ultimately included a tailored combination of antibiotic and supportive therapies.
Conclusions
This case highlights the diagnostic and therapeutic challenges of managing Brucella meningoencephalitis with concurrent conditions. Advanced diagnostic techniques were pivotal in the identification of each condition, and a personalized, multidisciplinary treatment approach was necessary due to the patient’s complex clinical state. This report adds to the body of knowledge on the neurologic complications of brucellosis and underscores the need for close monitoring of patients with relapsing symptoms and concurrent infections.