Influenzal meningitis

Abstract

Summary 1.One hundred and six cases of influenzal meningitis have been admitted to the Hospital for Sick Children, Toronto, from January, 1919, until June, 1936. 2.From 1919 to 1929 there were 70 cases not “specifically treated with serum,” with 69 deaths, a mortality rate of 98 per cent. The one patient who recovered received an exsanguination transfusion. 3.During the period 1930 to 1936, thirty-six cases were “specifically treated with serum,” with twenty-six deaths, a mortality rate of 72 per cent. 4.Bacteriologic investigations are reported. Evidence is presented that the few cerebrospinal fluid strains tested form a homologous series. Two nasopharyngeal strains from contact carriers were found to be serologically identical with the cerebrospinal fluid strain of the case. This finding suggests a carrier state similar to that found in meningococcic meningitis. 5.An outline of eleven cases of patients who recovered is given. 6.The use of the continuous intravenous injection of glucose-saline solution with anti-influenza horse serum given intravenously is recommended. In addition, repeated daily intrathecal injections of the combined serums should be given until several sterile spinal fluid cultures are obtained. 7.A fresh bactericidal guinea pig serum combined with anti-influenza horse serum was used in the treatment of two patients in which recovery took place. Summary 1.One hundred and six cases of influenzal meningitis have been admitted to the Hospital for Sick Children, Toronto, from January, 1919, until June, 1936. 2.From 1919 to 1929 there were 70 cases not “specifically treated with serum,” with 69 deaths, a mortality rate of 98 per cent. The one patient who recovered received an exsanguination transfusion. 3.During the period 1930 to 1936, thirty-six cases were “specifically treated with serum,” with twenty-six deaths, a mortality rate of 72 per cent. 4.Bacteriologic investigations are reported. Evidence is presented that the few cerebrospinal fluid strains tested form a homologous series. Two nasopharyngeal strains from contact carriers were found to be serologically identical with the cerebrospinal fluid strain of the case. This finding suggests a carrier state similar to that found in meningococcic meningitis. 5.An outline of eleven cases of patients who recovered is given. 6.The use of the continuous intravenous injection of glucose-saline solution with anti-influenza horse serum given intravenously is recommended. In addition, repeated daily intrathecal injections of the combined serums should be given until several sterile spinal fluid cultures are obtained. 7.A fresh bactericidal guinea pig serum combined with anti-influenza horse serum was used in the treatment of two patients in which recovery took place.