Salma Sakka, Nouha Bouzidi, Ines Feki, Wafa Abbes, Mariem Dammak, Masmoudi Jaweher and Chokri Mhiri
The involvement of the central peripheral nervous system (CNS) in brucellosis is rare. Cerebral venous thrombosis (CVT) is an exceptional complication. Only three cases were reported in literature. We reported the case of 52 year old Tunisian women that had psychiatric disorders since 2 years without treatment. She had brucellosis diagnosis by positive standard agglutination test and she was treated by doxycyline. She was admitted with the history of fever, headache, vomiting neck stiffness and confusion. Neurological examination found disorientation and meningeal signs. Brain Magnetic resonance imaging revealed a right lateral transverse sinus thrombosis. Blood culture grew Brucella melitensis and the brucella antibody titre was positive. Cerebrospinal fluid (CSF) analysis revealed lymphocytic meningitis. She was treated by anticoagulant (LMWH) and association of 2 antibiotics (doxycyline and rifampicin). During follow-up, we remarked a significant and rapid clinical improvement.