Neurobrucellosis in Children, a Report of 2 Cases

Objective: To report on two cases of neurobrucellosis with different presentations. Method: Retrospective report of the data on 2 cases of neurobrucellosis: the first case presented with acute meningo-encephalitis and the second case presented with acute meningitis. Result: Both cases had indolent fever for more than a month. The first case presented acutely with a diffuse maculopapular rash all over the body for 1 day prior to admission and a sudden deterioration of the level of consciousness, weakness, and generalized tonic-clonic convulsions lasting for 2 minutes. The history of the presenting illness indicated a strong history of contact with animals and animal products. The second case was presented to our hospital with history of fever on and off for 2 months and 1-day history of headache and neck pain, but no history of vomiting, convulsion, or loss of consciousness. Both cases were diagnosed by the serum agglutination test and cerebrospinal fluid Brucella culture. Both cases were treated for 6 months with combination therapy of anti-Brucella drugs with excellent outcome. Conclusion: These are rare and serious presentations of this common public health problem, unless the physician has a high index of suspicion, morbidity and mortality will not be prevented. So, the description of both cases and a brief review of the current pediatric literature are provided to familiarize pediatricians with the relatively rare presentations of this common worldwide disease.