Neurobrucellosis after a cranioplasty: A case report and literature review

Background: Brucellosis is a zoonotic infectious disease. Neurobrucellosis occurs when Borrelia burgdorferi infects the nervous system and is a complication of brucellosis. Infection is a common post-cranioplasty complication, although co-infection with B. burgdorferi is rare. In this article, we report a case of neurobrucellosis caused by B. burgdorferi infection after cranioplasty in a female patient with traumatic brain injury and review the literature. Case Description: A 37-year-old woman with traumatic brain injury underwent emergency clot removal and decompression craniectomy. Three-dimensional titanium mesh cranioplasty was performed 4 years later. Unfortunately, only 1 year later, the skull repair material had to be removed because of a localized scalp infection in the area of the skull repair. Cranioplasty was performed 5 months later with polyetheretherketone material. The patient remained free of symptoms until July 27, 2022, when the patient was readmitted for a headache. The final diagnosis of neurobrucellosis was made after relevant examinations, tests, and subcutaneous puncture of aspirated pus for bacterial cultures and special genus tests. Following the standard protocol, the patient was treated effectively. Conclusion: Neurobrucellosis occurs after a patient contracts a neurological infection through contact with the excrement of an infected animal or ingestion of food from an infected or diseased animal. Any postoperative complications of specific infections can cause physical pain and a heavy financial burden on the patient because of the special and expensive materials used for cranial repair. Therefore, we recommend screening patients from areas at epidemiological risk for relevant diseases before undergoing cranioplasty.