Commissions for complaints.

Brucellosis in Britain is usually caused by Brucella abortus and mainly affects those in direct contact with cattle or their unpasteurised milk products.1 2 Bone and joint brucellosis constitutes about 9° of brucellosis infections and the spine is the commonest site of skeletal infection.1 3Brucellar spondylitis most often presents with back pain and leg pain, resembling an intervertebral disc protrusion. Girdle pain has been reported.' 2 4 Paravertebral abscesses are uncommon in brucellosis.4 It is most unusual for brucellar spondylitis to present as right upper quadrant pain. A paravertebral abscess could produce nerve root and diaphragmatic irritation, resulting in right hypochondrial pain with radiation to the right shoulder tip. In skeletal brucellosis the cultures are frequently negative in keeping with the late stage of the disease.3 Early serological studies may be crucial to the diagnosis. Treatment with tetracylines and streptomycin is successful in most cases.1-4 Surgery is indicated for spinal brucellosis only if there is instability, vertebral collapse with cord compression, or failure of a thick walled paravertebral abscess to respond to medical treatment.4