Brucella Meningitis: Presentation, Diagnosis and Treatment - A Prospective Study of Ten Cases

Diagnosis of brucella meningitis was made in 10 patients byserological tests on blood and cerebrospinal fluid using RoseBengal, standard agglutination, indirect immunofluorescent andenzyme-linked immunosorbent assay (ELISA) tests and by bloodand CSF culture. All patients had significantly elevated antibodytitres. In three Br. melitensis was isolated both from bloodand CSF and in a further three from blood only. Eight patientswere 30 years old or less and seven were female. Seven patientshad a history of contact with livestock and had consumed rawmilk. Meningitis occurred in five, meningoencephalitis withhemiplegia in one, paraplegia and cranial nerve palsies in oneand psychosis and/or nightmares in three. Transient Parkinsonismwas seen in one patient and generalized rigidity and non-Parkinsoniantremors in another. Computerized tomography revealed ventriculardilation in one patient and punctate hyperdense, non-enhancingshadows in the lentiform nuclei in two others. Treatment witha combination of tetracycline, rifampicin and streptomycin wassuccessful.