Positive Brucella serological findings with incidental arteriovenous malformation: A case report

Brucellosis is one of the most important zoonosis. It causes significant economic and medical problems in countries throughout the world, including Iran. According to the available literature, brucellosis rarely causes intracranial space-occupying lesions. In this case study, we reported an intracranial mass in a 52-year-old male who were affected with brucellosis. The patient was referred to Vali-e-Asr hospital with right hemiparesis and transient speech impairment. The symptoms had begun sub-acutely and had gradually progressed. His past medical history was completely normal. Moreover, he had not consumed raw meat, had not been exposed to animal bite and slaughter within the recent weeks. In the initial assessment, the results of Wright agglutination and Coombs Wright tests level were 1/640 (a Wright’s titer of less than 1/80 is considered normal in Iran). The serum level of 2-Mercaptoethanol was 1/320 that was higher than the normal value. Brain-computer tomography (CT) scan and magnetic resonance imaging (MRI) were performed due to the inconsistency of neurologic findings with the usual presentations of brucellosis. MRI and CT scan findings showed a 35×35×34 mm heterogeneous mass lesion containing multiple vascular components located in the left paraventricular region along with mild peripheral edema and mass effect. Due to the size and the location of the lesion and the neurosurgery consultation, surgery was avoided and follow-up suggested. Treatment of brucellosis was initiated and completed according to the national protocol with rifampin and doxycycline. Follow up were performed in 6, 12, and 24 months after completion of the treatment. The growth of brain lesion was also controlled and the serologic test results of brucellosis were obtained normal.