Brucellosis is a multisystem disease with diverse clinical presentatio
ns, and involvement of the nervous system is considered to be rare in
childhood. Five children with meningitis (n = 2), meningoencephalitis
(n = 1), meningomyelitis (n = 1), or cerebellar ataxia (n = 1) are des
cribed, all of whom had a history of exposure to a possible source of
brucellosis. Examination of cerebrospinal fluid (CSF) revealed lymphoc
ytic pleocytosis in 4 patients, high protein concentration in 5 and lo
w glucose concentration in 3. Reciprocal brucella agglutination titers
were significantly elevated in serum (greater than or equal to 160) a
nd in CSF (greater than or equal to 80) of all patients. Brucella meli
tensis was isolated both from blood and CSF in one patient, from blood
only in 2, and from bone marrow only in another one. All patients wer
e treated successfully by a three-drug combination of streptomycin (4
patients) or doxycycline (one patient) with trimethoprim-sulfamethoxaz
ole and rifampin, and in one patient dexamethasone was also added. In
endemic areas, neurobrucellosis should be suspected in the evaluation
of patients with unexplained neurologic symptoms.