Is Neurobrucellosis the Pandora's Box of Modern Medicine?

TO THE EDITOR—The recent article by Guven et al [1], titled “Neurobrucellosis: Clinical and Diagnostic Features,” sheds light on many important yet vexing issues in the clinical presentation, diagnosis, andmanagementofarelativelycommon zoonotic infection. The relevance of discussing this issue is understated by the lack of consensus in the diagnosis and management of neurobrucellosis, in combination with unchanged diagnostic and therapeutic approaches for brucellosis being practiced for decades.Wewould like to express our views regarding certain aspects in the diagnosis and management of neurobrucellosis. The widely followed diagnostic criteria overemphasizes the role of abnormal cerebrospinal fluid (CSF) (positive Brucella agglutination titer in any titer, isolation of Brucella from CSF, and abnormal CSF parameters) in the diagnosis of neurobrucellosis [2]. However, in resourcepoor settings such as ours, facilities for determination of CSF Brucella agglutination titers are sparse. Due to the long