Özet:

Brucellosis is an infectious disease with multisystem involvement caused by the genus Brucella. Neurological complications including meningitis, meningoencephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess, and meningovascular syndromes are rarely encountered. We present a case of neurobrucellosis presenting with abducens nerve palsy and optic neuritis on the left side. Cerebrospinal fluid (CSF) findings indicated Brucella meningitis with high protein count, low sugar level and pleocystosis. In addition, Brucella agglutination test (Wright test) was found to be 1/160 in cerebrospinal fluid. Serum agglutination test for Brucella was also positive at 1/640. This case was diagnosed as brucellosis involving abducens and optic nerves. The patient was treated by ceftriaxone (intravenous), ciprofloxacin (orally) and doxycycline (orally). Four weeks after the treatment, the papilledema regressed, the left eye turned inward and double vision complaints decreased, and at the end of 12 weeks, all the patient's symptoms improved. No relapse was observed in the 1-year follow-up. We believe that neurobrucellosis should be considered among the differential diagnoses in patients with diplopia and sixth nerve palsy on examination in regions where brucellosis is endemic.

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