Psychotic Attacks Due To Toxic Neurobrucellosis in Two Adolescent Patients

Abstract

Brucellosis is a multisystem disease which can present with a broad spectrum of clinical manifestations and complications and affect the central nervous system directly or indirectly. Immunopathologic mechanisms like T-cell mediated cytotoxicity and microglia activation are suggested to play a role in neurobrucellosis. The diagnosis of toxic neurobrucellosis is confirmed by isolation of Brucella organism from blood cultures and/or positive Coombs Wright test and the Standard agglutination test (SAT) in serum when there are no cerebrospinal fluid (CSF) findings. The magnetic resonance imaging (MRI) of brain in patients with neurobrusellosis may show different findings mimicking such neurological diseases as inflammation, white matter changes and vascular involvements and other infectious and inflammatory conditions. Different clinical manifestations of neurobrucellosis have been described including meningitis, meningoencephalitis, myelitis, and psychiatric disorders. It has been indicated in case studies that neurobrucellosis may lead to psychotic disorders. In this study, we present two adolescents who presented with psychotic symptoms due to toxic neurobrucellosis.