We present the case of a 4-year-old boy who was admitted to hospital with intracranial hypertension, headache, diplopia, papilledema, and a normal brain MRI. Brucella melitensis in the cerebrospinal fluid was confirmed with PCR assay. We believe that neurobrucellosis should be included in the differential diagnosis when headaches persist following brucellosis. In addition, we suggest that when cerebrospinal fluid culture is negative, PCR may prove to be an optimal alternative tool for an immediate and accurate diagnosis. 1. Introduction Brucellosis is an endemic zoonotic disease, common in certain areas such as the Mediterranean basin, the Middle East, or South America [1, 2]. During the last decades, globalization and technology made worldwide traveling easy. These rather recent population shifts introduced a new era in the epidemic profile of many infectious diseases, changing their distribution, and making them reappear in places where they were previously considered eradicated. For example in 1991, the United Kingdom was declared brucellosis-free yet 148 new cases were reported during the period 2001–2006 amongst them three affecting the central nervous system, otherwise called neurobrucellosis [3]. There are many discrepancies in the diagnostic criteria of neurobrucellosis, and the literature is mainly restricted to case reports and short series [2]. 2. Case Presentation A 4-year-old boy was admitted to our institution because of vomiting and persistent headaches. One month before admission, he had been admitted to another hospital with fever and difficulty walking. Brucellosis is endemic in the region, and Wright agglutination test is routinely performed among other examinations for the differential diagnosis of fever combined with limb dysfunction. The test was positive and the patient was treated by intramuscular gentamicin, oral doxycycline, and rifampicin. Poor compliance to oral antibiotics secondary to vomiting resulted in readmission to our hospital. CBC showed lymphocytic pleocytosis (WBC count 7.400/mL, polymorphonuclear cells 42%, and lymphocytes 48%). Erythrocyte sedimentation rate, liver and renal function tests were normal. The Wright agglutination test for brucellosis in the serum was positive at a titer of 1？:？320. Fundoscopy showed obliteration of the left optic disc margin. An antibiotic regimen of cotrimoxazole and rifampicin was initiated. During the first week of admission, headaches worsened. Serial fundoscopy showed frank left side papilledema. Ocular movements revealed left abducens palsy and horizontal diplopia. Papillary
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