<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2301-1254</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Medicina]]></journal-title>
<abbrev-journal-title><![CDATA[Anfamed]]></abbrev-journal-title>
<issn>2301-1254</issn>
<publisher>
<publisher-name><![CDATA[Universidad de la República. Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2301-12542026000101401</article-id>
<article-id pub-id-type="doi">10.25184/anfamed2025v13n1a2</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Compromiso neurológico como manifestación de infección por Brucelosis: a propósito de un caso.]]></article-title>
<article-title xml:lang="en"><![CDATA[Neurological Involvement as a Manifestation of Brucellosis Infection: A Case Report.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Comprometimento neurológico como manifestação da infecção por brucelose: relato de caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salazar]]></surname>
<given-names><![CDATA[Emilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tapia-Villacis]]></surname>
<given-names><![CDATA[Steven]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Frantchez]]></surname>
<given-names><![CDATA[Victoria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pisani]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Hospital de Clínicas Dr. Manuel Quintela Instituto de Neurología]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de la República Hospital de Clínicas Unidad Académica de Enfermedades Infecciosas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la República Hospital de Clínicas Dr. Manuel Quintela Departamento de Salud Ocupacional]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>13</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S2301-12542026000101401&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S2301-12542026000101401&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S2301-12542026000101401&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: La neurobrucelosis es una complicación infrecuente de la brucelosis, que representa entre el 3 % y el 5 % de los casos y puede presentarse con manifestaciones neurológicas heterogéneas. Su diagnóstico suele ser dificultoso debido a la inespecificidad clínica y a la baja sensibilidad de los métodos microbiológicos convencionales.  Caso clínico: Se describe el caso de un paciente masculino de 26 años con antecedente de diabetes mellitus tipo 1 y exposición ocupacional a ganado bovino, que consultó por disminución progresiva e indolora de la agudeza visual bilateral. Durante la evolución presentó además hipoacusia neurosensorial bilateral. Los estudios de imagen fueron normales y las serologías resultaron positivas para Brucella abortus (IgG positiva, IgM negativa, aglutinación 1:320). Los estudios genéticos y el líquido cefalorraquídeo fueron negativos para otras causas. Recibió tratamiento combinado con doxiciclina, rifampicina y trimetoprima-sulfametoxazol durante seis meses, con recuperación completa de la función visual y auditiva.  Discusión: La coexistencia de neuropatía óptica y auditiva en un paciente con factores predisponentes metabólicos y ocupacionales constituye una presentación poco habitual de neurobrucelosis. La correlación clínico-serológica y el uso de terapias antibióticas prolongadas son fundamentales para el diagnóstico y el manejo exitoso.  Conclusión: Este caso resalta la importancia de mantener la sospecha diagnóstica de neurobrucelosis ante manifestaciones neurológicas atípicas y de instaurar un tratamiento combinado, prolongado y monitorizado para prevenir recaídas y secuelas neurológicas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  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.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A neurobrucelose é uma complicação incomum da brucelose, representando entre 3% e 5% dos casos, e pode apresentar manifestações neurológicas heterogêneas. Seu diagnóstico é frequentemente difícil devido à inespecificidade clínica e à baixa sensibilidade dos métodos microbiológicos convencionais.  Relato de caso:  Descrevemos o caso de um paciente do sexo masculino, de 26 anos, com histórico de diabetes mellitus tipo 1 e exposição ocupacional a bovinos, que apresentou perda progressiva e indolor da acuidade visual bilateral. Durante o curso da doença, ele também desenvolveu perda auditiva neurossensorial bilateral. Os exames de imagem foram normais e os testes sorológicos foram positivos para Brucella abortus (IgG positivo, IgM negativo, aglutinação 1:320). Estudos genéticos e análise do líquido cefalorraquidiano foram negativos para outras causas. O paciente recebeu terapia combinada com doxiciclina, rifampicina e trimetoprima-sulfametoxazol por seis meses, com recuperação completa das funções visual e auditiva.  Discussão:  A coexistência de neuropatia óptica e auditiva em um paciente com fatores metabólicos e ocupacionais predisponentes constitui uma apresentação incomum de neurobrucelose. A correlação clínico-sorológica e o uso de antibioticoterapia prolongada são essenciais para o diagnóstico e o tratamento bem-sucedido.  Conclusão:  Este caso destaca a importância de manter um alto índice de suspeita de neurobrucelose em casos de manifestações neurológicas atípicas e de iniciar terapia combinada prolongada e monitorada para prevenir recidivas e sequelas neurológicas.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Neurobrucelosis]]></kwd>
<kwd lng="es"><![CDATA[Brucella abortus]]></kwd>
<kwd lng="es"><![CDATA[Neuropatías del nervio óptico]]></kwd>
<kwd lng="es"><![CDATA[Pérdida auditiva neurosensorial]]></kwd>
<kwd lng="es"><![CDATA[Zoonosis]]></kwd>
<kwd lng="en"><![CDATA[Neurobrucellosis]]></kwd>
<kwd lng="en"><![CDATA[Brucella abortus]]></kwd>
<kwd lng="en"><![CDATA[Optic Neuropathy]]></kwd>
<kwd lng="en"><![CDATA[Hearing Loss, Sensorineural]]></kwd>
<kwd lng="en"><![CDATA[Zoonoses]]></kwd>
<kwd lng="pt"><![CDATA[Neurobrucelose]]></kwd>
<kwd lng="pt"><![CDATA[Brucella abortus]]></kwd>
<kwd lng="pt"><![CDATA[Neuropatias do nervo óptico]]></kwd>
<kwd lng="pt"><![CDATA[Perda auditiva neurossensorial]]></kwd>
<kwd lng="pt"><![CDATA[Zoonose]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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<article-title xml:lang=""><![CDATA[Diagnosis of early neurobrucellosis using metagenomic next-generation sequencing of cerebrospinal fluid in a non-epidemic zone: case report and literature review]]></article-title>
<source><![CDATA[Medicine (Baltimore]]></source>
<year>2025</year>
<volume>104</volume>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
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</article>
