Epidemic cerebro-spinal meningitis and its relation to other forms of meningitis : A report of the State Board of Health of Massachusetts.

  • Massachusetts. Department of Public Health.
Date:
1898
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Licence: Public Domain Mark

Credit: Epidemic cerebro-spinal meningitis and its relation to other forms of meningitis : A report of the State Board of Health of Massachusetts. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    well-built child of ten months, there was a history of slight gastro-intestinal disturbances two weeks before onset. The dis- ease began with restlessness, high fever (105° F.) and vomiting, the temperature continuing high until death, three days after onset. The autopsy showed fibrino-purulent exudation in the meninges of the brain, apparently extending down the cord, only the upper portion of which was removed with the brain. Pneumococci with well-marked capsules were found in the meninges, and cultures showed general pneumococcus infection. (We are indebted to Dr. Wentworth for the clinical notes on this case.) The other case was that of a child who was taken when six days old with general clonic convulsions, accompanied by a temperature of 104° in the first twelve hours, which afterwards dropped to 102°. The only symptoms were convulsions. Death occurred on the second day. The autopsy showed extensive exudation in the meninges of the brain (cord not examined). Microscopic examination of the exudation showed numbers of typical pneumococci. (Rotch, Pediatrics, p. 695.) Meningitis Due to Streptococcus. There were eight cases of this, and in all the meningitis was secondary to infection elsewhere. In four cases the primary infection was in the ear, and in two of these there was thrombosis of the lateral sinus. In one the meningitis repre- sented an extension to the meninges of an erysipelas of the face and scalp. In one case there was acute endocarditis, and in one the meningitis was secondary to an alveolar abscess. One case was of special interest, in showing an infection which doubt- less took place from the nose. In this case there was fracture of the base of the skull, extending across the cribiform plate of the ethmoid bone. Pus and abundant streptococci were found in the nose. In these cases the lesions in the meninges were very similar to those found in the pneumococcus infection. The exudation was purulent, with a variable amount of fibrin, usually not so much as in the pneumococcus cases. The acute endarteritis was well marked, and there was no extension of the process into the brain.