Seronegative neurobrucellosis—do we need new neurobrucellosis criteria?

• Main Authors: Vassilis E. Papadopoulos, Kostas Patas, Argyro Tountopoulou, Georgios Velonakis, Fotini Boufidou, Stylianos Chatzipanagiotou, Sofia Vassilopoulou
• Format: Article
• Language: English
• Published: Elsevier 2021-10-01
• Series: International Journal of Infectious Diseases
• Subjects: Brucellosis; Agglutination tests; Oligoclonal bands; RNA, ribosomal, 16S
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971221006718

Neurobrucellosis presents in various clinical forms and should always be considered in neurological patients in highly endemic areas such as the Mediterranean basin. Establishing a diagnosis can be challenging since serological testing can sometimes yield negative results. We present a rare case of a seronegative relapse of neurobrucellosis in a patient who had been successfully treated for systemic brucellosis. Oligoclonal bands, an agglutination test, and 16S rRNA sequencing of cerebrospinal fluid proved essential in unmasking a confined central nervous system relapse. This case reinforces the need for establishing diagnostic criteria for neurobrucellosis, which could potentially include oligoclonal bands and an agglutination test on the cerebrospinal fluid.