Anti-NMDA receptor encephalitis presenting with status epilepticus: Brucellosis as a possible triggering factor: A case report

Atousa Hakamifard, Seyed Navid Naghibi, Seyed Sohrab Hashemi Fesharaki

Abstract


Brucellosis is a common zoonotic infection caused by bacterial genus Brucella, a Gram‑negative bacterium, and continued to be a health problem in endemic areas. Anti‑N‑methyl‑d‑aspartate receptor (NMDAR) encephalitis is an autoimmune disease which can lead to status epilepticus. A 19‑year‑old male patient was referred to our hospital with status epilepticus. The diagnosis of
brucellosis was confirmed about 2 weeks before. The brain magnetic resonance imaging was normal. Lumbar puncture was performed, and cerebral spinal fluid (CSF) was in normal limits. The patient was treated with antiepileptic, anti‑brucellosis agents. Two weeks after discharge, the patient readmitted to hospital with status epilepticus again. Extensive workup was negative except that NMDAR antibodies were detected in serum and CSF. The diagnosis of anti‑NMDAR encephalitis was established. Brucellosis as a triggering factor for NMDAR encephalitis should be considered.

Keywords: Anti‑NMDA receptor, brucellosis, encephalitis, epilepsy, status epilepticus


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