Neurological complications are rare in childhood brucellosis: there are only 33 reported cases. In children, neurobrucellosis is usually of acute presentation involving the central nervous system. We report our experience with an 8-year-old boy with brucella meningitis who demonstrated a Jarisch-Herxheimer-like reaction, i.e. initial clinical deterioration following the commencement of antibrucella treatment, associated with increased pleocytosis and shift from lymphocytic to polymorphic predominance and an already increased CSF lactate.

These CSF findings have not been previously described. The patient recovered completely after 3 months\' therapy consisting of rifampicin, doxycycline and gentamicin. Paediatric neurobrucellosis therapy should be a combination of three antibrucella antibiotic that include an aminoglycoside; for a period of 8-12 weeks, steroids may be added to treat complications.

The prognosis of neurobrucellosis in children is usually good.

About the Authors

Habeeb YK, Al-Najdi AK, Sadek SA, Al-Onaizi E. (1998) Paediatric neurobrucellosis: case report and literature review. J Infect. 1998 Jul;37(1):59-62. Department of Paediatrics, Adan Hospital, Kuwait.