MENINGOCOCCIC MENINGITIS TREATED WITH SULFADIAZINE AND SULFAMERAZINE: A THREE YEAR STUDY

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Abstract
207 patients with meningococcic meningitis were treated during a 3-yr. period, using either sulfadiazine or sulf amerazine as the principal therapeutic agent. Gross mortality was 10.1%. There was no significant difference in the case fatality rate in patients treated with the 2 drugs. The number of patients treated, the case fatality rate, and the duration and severity of illness were less in 1944 than in 1943. The etiologic diagnosis was established immediately from direct examination of the cerebrospinal fluid in 188 (90.8%) of this group of 207 patients. The factors of the greatest prognostic significance at the time of admission were the presence or absence of the coma-delirium state and the age of the patient. In patients who were delirious or in coma, the finding of numerous microorganisms in or the virtual absence of dextrose from the initial specimen of cerebrospinal fluid added to the gravity of the prognosis. There was no relationship between the conc. of the sulfonamide in the blood and the outcome in meningitis. Massive doses of these drugs are not necessary for most patients with meningococcic meningitis. Careful appraisal of patients and of the findings in the cerebrospinal fluid will indicate those patients who require more vigorous treatment.