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35 years old female patient not known to have any medical or psychiatric illness. |
Current illness
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May 2020 |
Patient started to have on and off headache, numbness of the left hand, blurred vision, night sweats. |
08 June 2020 |
Patient presented to ER with psychiatric symptoms in form of behavioral changes, inappropriate speech. Patient was admitted under psychiatry department and was discharged in good condition after 3 days. |
23 June 2020 |
The patient visited our neurology clinic for the first time where a detailed history and examination were made. |
Physical examination
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23 June 2020 |
within normal limits |
Diagnostic evaluation
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24 June 2020 |
Brucella antibody test in blood sample: positive for abortus and melitensis, CSF analysis: demonstrates Leukocytosis with predominant lymphocytosis. |
28 June 2020 |
Diagnosis was made. |
Initial treatment
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28 June 2020 |
Rifampicin 600 mg OD, doxycycline 100 mg BID, and moxifloxacin 400 mg OD. |
Ongoing treatment
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06 August 2020 |
Moxifloxacin was administered for 6 weeks, then stopped, and continued on rifampicin and doxycycline for a total of 12 weeks with a frequent follow up with infectious disease and neurology clinics. |
Final follow up
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06 August 2020 |
Follow up spinal tap after one month reported normal cell count. Patient completed her antibiotic course for more 6 weeks with significant improvement. |