To investigate the clinical manifestation and treatment of brucella cephalomeningitis.

The clinical data about the epidemiological information, clinical manifestations, etiologies, CSF examination, and imaging features of 32 patients with brucella cephalomeningitis were analyzed, retrospectively.

The research objects included 28 male and 4 female patients, with the mean age of (43 ± 16) years old, while unambiguous epidemiologic evidence had been found in all of patients. The main clinical features of patients included fever, fatigue, sweating, headache, vomiting and neck resistance, while consciousness obstacle was rarely found. The Brucella serum agglutination test were positive, 7 cases were positive for the Brucella cerebrospinal fluid (CSF) agglutination test and 9 cases (28.1%) were positive for blood culture of Brucella. The biochemical results in cerebrospinal fluid were similar with those in viral meningitis or tuberculous meningitis. Head MRI examinations had found 3 cases (9.4%) with brain abscess, 2 cases (6.3%) with pituitary abscess, 3 cases (9.4%) with hydrocephalus, 3 cases (9.4%) with demyelinating lesions, 3 cases (9.4%) with old infarction, and 1 case (3.1%) with left frontal subcortical ischemic focal. All the patients got a favorable prognosis, after receiving combined treatment with doxycycline, rifampicin, cefotaxime sodium and sulbactam tantra or ceftriaxone. The median duration of treatment is 6 months. Refractory cases received fluoroquinolone, aminoglycoside treatment or compound paediatric compound sulfamethoxazole tablets treatment.

A comprehensive inquiry of epidemiology were conducive to diagnose Brucellosis earlier. Whether a nervous system lesion was the complication of brucellosis should be distinguished by doctor. Interrogation of epidemiologic history could be used to early detection of undulant disease, timely diagnosis and aggressive treatment was the key to improve the prognosis.