CENTRAL-NERVOUS-SYSTEM BRUCELLOSIS - PRESENTATION, DIAGNOSIS AND TREATMENT

Although neurological symptoms in brucellosis are frequent,, central n ervous system (CNS) involvement is uncommon. Five patients with neurob rucellosis are presented. Three patients presented with meningoencepha litis, one with polyradiculoneuritis and one with myelitis and an eigh th nerve palsy. All patients had lymphocytic pleocytosis, low glucose and elevated levels of protein in the cerebrospinal fluid (CSF). Gamma -globulin and IgG values in the CSF were also increased. Results of ag glutination tests for Brucella in serum and CSF were positive for all patients, although titres were less in the CSF. Brucella melitensis wa s cultured from two patients. Treatment included concurrent administra tion of three of the following drugs: doxycycline, rifampicin, strepto mycin, co-trimoxazole, ceftriaxone or ciprofloxacin. The three patient s with meningoencephalitis fully recovered; the other two patients wer e left with minor disability.