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Brucellosis, caused by Brucella, dominates in the Middle East. Acute or chronic brucellosis can involve any organ system, and the involvement of the central nervous system leads to encephalitis, called neurobrucellosis (NB). We report a rare case from north India where a variant of Brucella caused NB led to progressive labyrinthine dysfunction; who developed vertigo, disequilibrium, and gradual progressive sensorineural (SN) hearing loss. Audiological tests pure-tone audiometry (PTA), otoacoustic emissions (OAE), stapedial muscle reflexes, auditory evoked brainstem responses (ABR), and vestibular evoked myogenic potentials (VEMPs) were conducted on the patients. PTA showed a bilateral profound SN hearing loss, an absent OAE, and ABR suggestive of cochlear dysfunction. The cervical and ocular VEMP showed delayed n1 and p1 latencies, suggesting superior and inferior nerve branch involvement. Vertigo or disequilibrium and SN hearing loss can be the late-onset manifestations of labyrinthine dysfunction in chronic Brucella-induced encephalitis. [ABSTRACT FROM AUTHOR]

In India, brucellosis is an often neglected zoonotic disease. Consumption of unpasteurized milk causes transmission of this infection to humans. Brucellosis can affect any organ in the body including the brain. However, the diagnosis is often missed as the clinical presentation of neurobrucellosis is atypical and can be confused with other diseases such as tuberculosis and Lyme disease. Therefore, laboratory investigations are critical for the diagnosis of this infection. Drugs such as doxycycline, rifampicin, and ceftriaxone are useful in the treatment of neurobrucellosis as it penetrates well into the central nervous system (CNS). We report a case of a 45-year-old man presenting with meningitis caused by Brucella melitensis because of the relative rarity of the neurobrucellosis in India. [ABSTRACT FROM AUTHOR]