Seronegative neurobrucellosis-do we need new neurobrucellosis criteria?

Neurobrucellosis presents in various clinical forms and should always be considered in neurological pa-tients in highly endemic areas such as the Mediterranean basin. Establishing a diagnosis can be challeng-ing since serological testing can sometimes yield negative results. We present a rare case of a seroneg-ative relapse of neurobrucellosis in a patient who had been successfully treated for systemic brucellosis. Oligoclonal bands, an agglutination test, and 16S rRNA sequencing of cerebrospinal fluid proved essential in unmasking a confined central nervous system relapse. This case reinforces the need for establishing diagnostic criteria for neurobrucellosis, which could potentially include oligoclonal bands and an aggluti-nation test on the cerebrospinal fluid. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Automated summary

Neurobrucellosis can present in various clinical forms and diagnosis can be challenging, requiring multiple testing methods such as analysis of cerebrospinal fluid and serological testing. This case highlights the importance of establishing diagnostic criteria for neurobrucellosis.