A Survey of Recent Developments in the Treatment of Pneumococcal Meningitis

Jackson, W. P. U.

doi:10.1136/adc.25.121.22

Cited by 13 publications

(1 citation statement)

References 38 publications

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“…Seizures complicating bacterial meningitis have been previously shown to have an adverse effect on mortality and morbidity, and these studies also demonstrate increased mortality among patients who were convulsive during the course of bacterial meningitis. 25,26 Seizures occurred in 71% (10/14) of our patients with cerebral infarctions, and it is a statistically significant risk factor associated with cerebral infarctions in our study. Although a rapid deterioration of consciousness should raise suspicion of ventricular dilation, cerebral infarctions and the severity of bacterial meningitis may play a much more significant role than hydrocephalus in altering the level of consciousness, and disturbed consciousness on admission was a risk factor associated with cerebral infarction in our study.…”

Section: Discussionsupporting

confidence: 52%

Cerebral infarction in perinatal and childhood bacterial meningitis

Chang¹,

Chang²,

Huang³

et al. 2003

QJM

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There was a high prevalence of cerebral infarctions when the disease was caused by S. pneumoniae and Salmonella species. Occurrence was highest in the first year of life, and the prognosis in this patient group is poor. Risk factors associated with cerebral infarction in our patients included age 28-365 days, seizures, hydrocephalus, disturbed consciousness on admission, and high CSF lactate concentrations.

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Section: Discussionsupporting

confidence: 52%

Cerebral infarction in perinatal and childhood bacterial meningitis

Chang¹,

Chang²,

Huang³

et al. 2003

QJM

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Treatment of Pneumococcic Meningitis

Lepper¹

1959

AMA Arch Intern Med

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The results of treatment of patients with pneumococcic meningitis have varied widely.1-21 While some of the variations may be attributed to the choice of treatment, particularly with antibacterial agents, the magnitude of differences has been as great between different clinics using the same regimen as between different regimens in the same clinic. Several factors, such as the quality of supportive treatment and availability of nursing services, may influence results, but the nature of the patient being treated appears to be of primary importance. This is emphasized by analysis of the difference in results in various age groups and of the complicating diseases and the acuity of the illness among those patients who die as compared with those who recover.The effect of factors of selection of patients entering a hospital on prognosis made the study of this disease by alternate case method seem necessary. Because of the fact that rapidity of action should be desirable in pneumococcic meningitis, in which death occurs in many cases within a few hours or one to two days, it was thought that a combination of rapidly bactericidal drugs, such as streptomycin and penicillin, might be more effective than penicillin alone. The efficacy of this combination of drugs in endocarditis caused by a-hemolytic strep-tococci furthered this hope. Moreover, because the course of patients with pneumococcal meningitis suggested early and marked irreversible tissue damage, we be¬ gan, in 1950, to use the adrenal corticosteroids in an attempt to reduce this damage and thereby preserve life and function until the antibiotics had an opportunity to work. As previously reported,22 however, the use of these agents in patients who were con¬ sidered to be in a critical condition was not rewarding, and in 1955, it was decided that earlier use might give better results. For this reason, beginning at that time, a separate alternation of patients was begun, in which there was an attempt to estimate the worth of hydrocortisone. MethodAll patients were treated on the wards of the Municipal Contagious Disease Hospital of Chicago.In this institution every attempt was made to start treatment as promptly as possible. In almost all patients, this was accomplished by the complete work-up in the admitting suite, where the history and physical examination were done and a lumbar puncture performed when meningitis was suspected. The fluid was examined immediately for bacteria, and if Diplococcus pneumoniae ( pneumococci ) were seen the patient was placed in one of the two antibiotic groups. If no D. pneumoniae or other organisms were seen but the spinal fluid appeared to be that of a purulent meningitis and the patient was more than six years old, he was placed in the appropriate group on the presumptive diagnosis of pneumococcal meningitis. Hence, these latter patients, in whom the etiologic diag¬ nosis could not be made by examination of an initial stained smear of the spinal fluid, were al¬ ternated separately, and when the subsequent cul¬ tures established a ...

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Meningitis in childhood

Chaudhuri

1953

Indian J Pediatr

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A Survey of Recent Developments in the Treatment of Pneumococcal Meningitis

Cited by 13 publications

References 38 publications

Cerebral infarction in perinatal and childhood bacterial meningitis

Cerebral infarction in perinatal and childhood bacterial meningitis

Treatment of Pneumococcic Meningitis

Meningitis in childhood

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