Shuzhu Cao,1,* Songsong Xie,2,* Shengnan Song,1,* Xiu Gu,2 Zhihua Sun,1 Xingmei Deng,1 Jia Guo,1 Tianyi Zhao,1 Yingjin Chai,1 Dexin Zhu,1 Xiafei Liu,3 Xiangwei Wu,2 Hui Zhang1 

1State International Joint Research Center for Animal Health Breeding, College of Animal Science and Technology, Shihezi University, Shihezi, People’s Republic of China; 2NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, The First Affiliated Hospital of Shihezi University, Xinjiang, People’s Republic of China; 3National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Prevention and Control, Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiangwei Wu; Hui Zhang, Email wxwshz@126.com; prof.zhang@foxmail.com

Background: Brucellosis, a major endemic disease in northern China, is contracted by zoonosis of Brucella. We report a case of meningitis caused by Brucella melitensis biovar 3.
Case Presentation: A 46-year-old man was hospitalized at a local medical facility due to symptoms of fever, soreness, and weakness on April 16, 2021. The local hospital improved the relevant examinations, and the serum tube agglutination test (SAT) for Brucella was positive. The patient underwent a week of anti-infective symptomatic treatment with doxycycline and rifampicin, however, his symptoms continued. Subsequently, he was hospitalized in our facility following convulsions and altered consciousness. We conducted several examinations, and the lumbar puncture revealed abnormal cerebrospinal fluid (CSF) protein levels along with a positive culture. Biochemical and polymerase chain reaction (PCR) tests (based on IS711 gene) identified the pathogen as B. melitensis biovar 3. Following treatment involving with moxifloxacin hydrochloride, doxycycline, rifampin, cefatriaxone, mannitol, and dexamethasone the patient’s body temperature stabilized, leading to gradual improvements in his clinical status. After two months of the oral anti-infective regimen, the condition is continuing to alleviate and the laboratory indicators returned to normal. The follow-up maintained two years, the patient with no symptomatic recurrences or sequel.
Conclusion: We showed that in epidemic areas of brucellosis, patients with unexplained neurological symptoms should first be examined for neurobrucellosis. Early treatment with corticosteroids and a combination of antibiotics is beneficial for the relief and satisfactory prognosis of neurological symptoms.

Keywords: Brucella melitensis biovar 3, meningitis, shepherd, treatment