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This case represents the first diagnosis of pachymeningitis due to granulomatosis with polyangiitis (GPA) in an elderly Iranian man who initially presented with persistent daily headaches. PCR tests of cerebrospinal fluid for tuberculosis, brucellosis, and fungal infections all yielded negative results. Given the pachymeningitis pattern observed on brain MRI and the absence of infectious and lymphoma diseases, along with positive anti-PR3 and proteinuria (793 mg in a 24-h urine sample), a diagnosis of GPA was established.

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Article Synopsis
  • * The study presents two cases of patients misdiagnosed with intracranial infections when they actually had MPO-ANCA-positive HP, highlighting the difficulty in distinguishing between the two conditions based on initial symptoms and treatment responses.
  • * To improve diagnostic accuracy for patients with headaches and other related symptoms, the authors recommend testing for ANCA antibodies, as prompt recognition of MPO-ANCA-positive HP can lead to effective treatment with glucocorticoids and immun
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Neurobrucellosis is rare in children, presenting with a variety of clinical manifestations, including meningitis, meningoencephalitis, cranial neuropathies, and intracranial mass-like lesions. We present a case of a 17-year-old girl admitted to the hospital in Istanbul for headache. Lumbar puncture showed elevated intracranial pressure, monocytic pleocytosis, elevated total protein, and hypoglycorrhachia.

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Brucellosis is a zoonotic disease caused by small intracellular aerobic Gram-negative bacilli The literature has frequently documented instances of the gastrointestinal, hepatobiliary, and skeletal systems being involved. In 3%-5% of brucellosis patients, neurobrucellosis has been identified. Guillain-Barré syndrome (GBS) is a disorder of the peripheral nervous system.

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