A Rare Case of Neuralgic Amyotrophy Associated with Brucella Infection

Abstract

Multiple micro-organisms associated with Neuralgic Amyotrophy (NA) have been reported and Brucella species should be an important and overlooked infectious cause or trigger.We report a rare case of neuralgic amyotrophy associated with Brucella infection and is believed to be the first such case report in China. A 42-year-old male with brucellosis was confirmed serologically, who presented recurrent fever and fatigue and suddenly developed severe pain in the right shoulder within one week, followed by the inability to lift and abduct the proximal end of the right upper limb. Based on typical clinical manifestions, MRI neuroimaging of the brachial plexus and neuro-electrophysiological studies to confirm a diagnosis of NA and presented spontaneous recovery during this period, immunomodulatory treatment with corticosteroid or intravenous immunoglobulin had not been attempted, leaving a serious movement disorder in the right upper limb. Even rare, NA and other neurobrucellosis forms should be considered as complications of Brucella infection.

Keywords:

• Brucella infection
• neuralgic amyotrophy
• immune-mediated nature
• diagnosis and treatment

Abbreviations

NA, Neuralgic Amyotrophy; GBS, Guillain-Barre Syndrome; RBPT, Rose Bengal Plate Test; SAT, Serum Agglutination Test; WBC, White Blood Cell; AST, Aspartate aminotransferase; PIT, Platelet; GGT, Glutamine transpeptidase; LAP, Leucine arylamidase; GLDH, Glutamate dehydrogenase; ALP, Alkaline phosphatase; EMG, Electromyography; MCV, Motor Conduction Velocity; MRI, Magnetic Resonance Imaging; MNAP, Median Nerve Action Potential; CMAP, Compound Muscle Action Potential; Lat, Latency; Amp, Amplitudes; MU, Motor Unit.

Patient Consent and Ethics Statement

The study was carried out in accordance with the recommendations of the Ethics Committee of the China-Japan Union Hospital of Jilin University. A written permission for the use of patient data for publication of this cases report and accompanying images was obtained.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests for this study.

Additional information

Funding

This study did not receive any funding.