Introduction:

Neurobrucellosis is a rare complication of brucellosis, accounting for 3-5% of cases and may present with a wide range of neurological manifestations. Diagnosis is often challenging due to nonspecific clinical findings and the low sensitivity of conventional microbiological methods.

Case report:

We describe a 26-year-old male with type 1 diabetes mellitus and occupational exposure to cattle who presented with progressive, painless bilateral visual loss. During follow-up, he developed bilateral sensorineural hearing loss. Neuroimaging was normal, and serology was positive for Brucella abortus (IgG positive, IgM negative, agglutination 1:320). Cerebrospinal fluid analysis and genetic testing for alternative causes were negative. The patient received combination therapy with doxycycline, rifampicin, and trimethoprim-sulfamethoxazole for six months, achieving complete recovery of visual and auditory function.

Discussion:

The coexistence of optic and auditory neuropathy in a patient with metabolic and occupational risk factors represents an uncommon form of neurobrucellosis. Clinical-serological correlation and prolonged combined antibiotic therapy are essential for accurate diagnosis and management.

Conclusion:

This case underscores the importance of considering neurobrucellosis in patients with atypical neurological manifestations and of initiating early, prolonged, and combined antimicrobial therapy to prevent relapse and neurological sequelae.

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