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Twenty-one patients with spinal brucellosis were reviewed. The disease is difficult to diagnose, and is often confused with spinal tuberculosis. Our study showed that it was best diagnosed by serology 2nd bacterial culture; radiography and scanning were less helpful in the early stages. After only six weeks' antibiotic treatment, there was a 55% clinical and serological reactivation rate: better results were achieved after at least three months of treatment. The adequacy of treatment was best monitored with repeated agglutination titres, and the duration of freatment proved to be more important than the antibiotic agent itself. Surgical intervention was reserved for biopsy, severe neurological impairment, or for spinal stabilisation. Brucellosis remains a serious infectious disease and an important cause of morbidity in both animals and man.

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We treated six patients with nervous system brucellosis causing polyradiculitis (2 patients), myelopathy (2), encephalitis (1), or meningitis (1). Diagnosis was based on Brucella species cultured from one patient, and a twofold or greater rise in antibody titer after therapy was started in the others. Treatment with trimethoprim-sulfamethoxazole with rifampin (5 patients) or tetracycline (1 patient) produced excellent clinical and laboratory response.

Human brucellosis is usually caused by one of three species of the genus Brucella: melitensis, abortus, and suis; it is rarely caused by Brucella canis.3 Brucellae are small, non-motile, gram negative capnophilic coccobacilli with optimum growth at temperature of 37°C and a pH of 6-6-6-8. Brucellosis is found primarily in animals and is spread to man by direct contact with infected tissue or by ingestion of infected animal products, most commonly milk or milk products. In Westem countries, brucellosis is an occupational disease found mainly in farmers, people working in meat packing plants, veterinary surgeons, and livestock producers. In other areas of the world the disease is more widespread and is found in the general population.