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Dangerous in all circumstances, purulent meningitis is even more life-threatening in tropical areas. This results from underlying malnutrition, haemoglobinopathy and enzymopathy, but also from delays in treatment. We have treated 28 patients, 16 boys and 12 girls, aged from 16 days to 7 years suffering from purulent meningitis, with cefotaxime. Almost half of the patients were suffering from malnutrition and low body weight, or from haemoglobinopathy. Cefotaxime, administered 2 or 3 times daily intramuscularly, was given at 90 to 200/mg/kg with a mean of 150/mg/kg/day. Overall, results showed a 79% cure rate including 71% complete recovery, the highest ever seen in the department.