Brucella Shunt Infection as a Rare Presentation of Neurobrucellosis

Brucellosis, as a systemic infection with potential to involving virtually all organ systems, is an endemic zoonosis in Iran. This is the history of a 17-year-old boy with a ventriculoperitoneal (VP) shunt who presented with prolonged fever, constipation, and abdominal pain. Laboratory studies, including cerebrospinal fluid (CSF) and blood tests, revealed a VP shunt infection with Brucella spp. We treated the patient with rifampicin, trimethoprim-sulfamethoxazole (cotrimoxazole), and ceftriaxone. Also, the shunt was temporarily replaced with an extraventricular drain until the CSF culture was sterile and a new permanent VP shunt could be inserted. We report this case to underline the diagnostic possibility of brucellosis in every case of protracted fever of unknown origin (FUO), irrespective of accompanying signs and symptoms.