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Background: Brucellosis is an endemic infectious disease in Iran. The neurological involvement of the central nervous system in brucellosis patients is about 3 to 5 %. Case: The case was a 25-year old Afghan man with weakness and arthralgia for one year as well as terrible headache, vertigo, vomiting, cough, sputum, and disequilibrium. Brain CT-Scan indicated communicating hydrocephalus in four ventricles. Since hydrocephalus was idiopathic and noticing the prevalence of tuberculosis among Afghan immigrants that can also cause hydrocephalus, ventriculo-peritoneal shunt was inserted for the patient. Pressure in CSF increased and had a turbid appearance. Glucose value of CSF decreased (35 mg/dl), whereas protein value increased (724 mg/dl). Leukocyte count was 10 mm3 with 80% neutrophils and 20% lymphocytes. The presence of brucella species in CSF culture confirmed that subacute meningitis had caused hydrocephalus due to delay in diagnosis and treatment. The patient was treated for brucellosis and discharged after 10 days with oral medications. Conclusion: Noticing this case and other studies, it is recommended that patients with neurological symptoms, such as hydrocephalus, be evaluated for neuro-brucellosis in endemic areas for brucellosis.

Keywords: Hydrocephalus, Meningitis, Neuro-brucellosis

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