Penicillin treatment of pneumococcus meningitisin infants

Abstract

T HE employment of penicillin as a new agent in the treatment of pneumococcus meningitis calls for a re-evaluation of the prognosis and a discussion of the therapeutic problems involved. Previous reports on the use of penicillin in this formidable disease have dealt chiefly with adults or older children, 1-4 except for the recent article by Waring and Smith 5 and individual case reports. Fourteen cases of pneumococcus meningitis in children under 2 years of age were treated with penicillin in the Infants ' and Children's Hospitals between Sept. 20, 1943, and Dec. 28, 1944. I t is the purpose of this study to present an analysis of these cases in an attempt to evaluate this form of therapy. The series is admittedIy small and the results not entirely conclusive, inasmuch as the patients deserve a longer period of follow-up before it can be said to what extent they may be considered normal individuals and therefore cured. The eases presented here serve to emphasize the problems which one encounters in the treatment of this type of meningitis in the infant age group, particularly in infants, under t year. A few years ago the mortality rate for pneumoeoecus meningitis was practically 100 per cent for all ages. Specific antiserum combined with sulfonamides brought about an encouraging number of recoveries in children over 2 years of age 6 and in adults, but only rarely did an infant survivC (Fig. 1). Why this should be is not entirely clear. Several observations concerning the immunologic status of infants suggest not only a greater susceptibility s but also a lack of antigenic response 9 of infants to pneumococcus infections.