A Cluster of Neurobrucellosis at King Hussein Medical Center, Jordan - A Comprehensive Analysis And Review.

In this retrospective review, we describe the neurological clinical manifestations infive cases diagnosed with neurobrucellosis over two years between 2018 and 2020,and the application of different proposed criteria for establishing the diagnosis andtreatment of neurobrucellosis. All cases were confirmed to have brucellosis withlaboratory tests, and all were living in Jordan, which is considered part of a highlyendemic area within the Middle East. The neurobrucellosis proposed criteria wasapplied, which requires signs and symptoms consistent with neurobrucellosis,presence of anti-Brucella antibodies in cerebrospinal fluid and serum with or withoutisolation of Brucella species in CSF and serum, cerebrospinal fluid analysis shows:lymphocytosis, high protein level, and low glucose level and radiological findings onMRI or CT. In all five cases, we have confirmed direct contact with animals or animalproducts either as a consumer or as a farmworker. Their signs and symptoms wereconsistent with brucellosis. In all cases, haematological and CSF results, in addition toimaging findings using magnetic resonance and computed tomography, were highlycoherent with neurobrucellosis. Neurobrucellosis can present with different clinicalmanifestations, either as a sole site of infection like acute or subacute meningitis ormyelitis, or in context of a multi variable systemic disease. In patients with unusualneurological clinical presentations, and those with persistent chronic symptoms likeheadache, malaise, or depression, neurobrucellosis should be highly suspected,especially in endemic areas. Such patients must have a prolonged course of antibioticsbetween 6 to 18 months with close monitoring of their serum and CSF examination