Case Report: Neurobrucellosis Presenting as Malignancy

Abstract

Neurobrucellosis, caused by Brucella species, is a zoonotic infection that may involve the central nervous system. Although uncommon, it can manifest as a solitary intracranial mass. We report a case of neurobrucellosis in a 25-year-old woman from Peru who presented with headache, weight loss, and right-side hemiparesis and paresthesia. A contrast-enhanced magnetic resonance imaging scan revealed an intracerebral mass in the left temporal lobe. Serum testing subsequently were positive. Brain biopsy demonstrated non-necrotizing granulomas without malignant cells. Neurobrucellosis should be considered in the differential diagnosis of brain space occupying lesions in endemic countries.

Figure 1.

(A) Axial T1-weighted contrast-enhanced magnetic resonance imaging reported cerebral mass in left temporal lobe with peripheral edema (red arrow). (B) Fluid attenuated inversion recovery sequence showing expansive lesion in temporal lobe (red arrow). Both sequences showed a shift of midline.

Figure 2.

(A–C) Hematoxylin and eosin–stained microphotography of brain parenchyma revealed a dense lymphocytic inflammatory infiltrate with the formation of non-necrotizing granulomas and multinucleated giant cells. Congestion and edema of the neuropil were also noticed.

Figure 3.

At 6-month follow-up, (A) axial T1-weighted contrast-enhanced magnetic resonance imaging and (B) fluid attenuated inversion recovery sequence showed a noticeable decrease in the lesion of the temporal lobe.