Neurobrucellosis associated with feral swine hunting in the southern United States

BMJ Case Rep. 2020 Dec 21;13(12):e238216. doi: 10.1136/bcr-2020-238216.


Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.

Keywords: exposures; infection (neurology); meningitis.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Animals, Wild / microbiology*
  • Anti-Bacterial Agents / therapeutic use*
  • Brucellosis / complications
  • Brucellosis / diagnosis*
  • Brucellosis / drug therapy
  • Brucellosis / microbiology
  • Drug Therapy, Combination / methods
  • Headache Disorders / drug therapy
  • Headache Disorders / microbiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Memory Disorders / drug therapy
  • Memory Disorders / microbiology
  • Meninges / diagnostic imaging
  • Meningitis, Bacterial / complications
  • Meningitis, Bacterial / diagnosis*
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / microbiology
  • Middle Aged
  • Swine / microbiology*
  • United States


  • Anti-Bacterial Agents