Subdural Empyema Caused by Brucellosis: A Case Report and Review of the Literature

Abstract

Neurobrucellosis is a rare and challenging complication of brucellosis. Its non-specific clinical presentation makes it challenging to diagnose. The coexistence of neurobrucellosis with subdural empyema is extremely rare, with only a few cases reported in the literature. Herein, we present the case of a 27-year-old male with a ventriculoperitoneal shunt in-situ and a history of exposure to Brucella via animal care and consumption of raw milk. The patient presented with a left frontal headache and vertigo following a head trauma. The initial cranial imaging demonstrated a left-sided subdural hematoma and slit ventricles. The patient underwent drainage by craniotomy. Brucella spp. was detected in the drained sample, and the patient was treated with a multi-modal approach, which included antibiotics and surgical drainage. The follow-up plan involved a repeat cranial computed tomography and shunt adjustment for recurrent subdural effusions. This case adds to the few reports of neurobrucellosis associated with subdural empyema. Furthermore, it highlights the importance of considering neurobrucellosis in patients with neurological symptoms and a subdural collection in brucellosis-endemic areas.

Keywords

• subdural hematoma
• brucella
• ventriculoperitoneal shunt
• case report