Pneumococcic Meningitis

Abstract

CONSIDERATION of the literature dealing with the mortality associated with pneumococcic meningitis focuses attention on two points. First, there appears to be a marked divergence in mortality statistics as reported by different investigators, estimates ranging between 25 1 and 70%.2 Second, in spite of the recognized natural susceptibility of the Pneumococcus to penicillin, as evidenced by the sharp reduction in pneumococcic pneumonia mortality, 60 to 9%,3 when this therapeutic agent is used and the reported synergistic activity of penicillin and sulfonamides against this organism,4 the mortality associated with the Pneumococcus when it invades the meninges was, until recently, inordinately high. These considerations, together with a desire to compare our experience in the light of that of others, prompted us to make this study.Our series embraces the clinical and autopsy records of 102 cases of pneumococcal meningitis seen at the Philadelphia General Hospital during the past decade.Of the total number of cases reviewed, autopsy records were available in 68. In analyzing the series an attempt has been made to determine the effect on mortality rate of such factors as (1) age, (2) primary focus of infection, (3) coma, (4)

A Follow-up Study of 110 Patients Treated for Purulent Meningitis

“…after only eight hours, even when penicillin was given intravenously in the extremely high dosage of 1,000,000 units two-hourly. According to Alexander, Flippin and Eisenberg (1953), the pneumococci show a delayed growth in a concentration of the penicillin of 0 03 units per ml., so one can only expect any effect from penicillin injected intravenously after eight hours. By giving the penicillin intrathecally one might be able to reduce this delay.…”