Pneumococcic Meningitis in Infants and Children

On the Management of Oto-Rhinogenic Intracranial Infections

“…There is at present a revulsion from intrathecal administration of penicillin, streptomycin and other antibiotics in the treatment of bacterial leptomeningitis. Reasons adduced are that such drugs so administered may produce meningeal irritation and even fibrosis; lumbar punctures may be distressing, may upset intracranial pressure balances-which may be serious when there is also another lesion such as a cerebral abscess-and incur some risk of introducing secondary infection (also Gordy, 1952;Heckler, 1952;Nemir and Israel, 1951;Ellis, 1954). On the other hand, Gibson and James (1952) consider that omitting to do lumbar punctures with antibiotic instillations in pneumococcal meningitis leads to worse results^Accidental excessive intrathecal or intraventricular dosage of penicillin jnay cause convulsions, arachnoiditis, coma, pareses (Dohlman and Holmgren, 1950;others), fibrotic obstruction of a foramen of Monro (Alexander and Botterell, 1949).…”