Streptococcal viridans meningitis followed by pneumococcal meningitis in the same patient with recovery

Abstract

Summary 1. A case is presented in which a patient had streptococcal viridans meningitis and was cured by combined sulfadiazine and penicillin therapy. Three months later the same patient developed pneumococcal meningitis and was again cured by the same therapy. 2. For the streptococcal meningitis, sulfadiazine was used at first with equivocal results. Penicillin was added and recovery occurred promptly. For the second infection both forms of therapy were used at the onset. Penicillin was used both intramuscularly and intraspinally. 3. The focus of infection for the streptococcal viridans meningitis was felt to be several diseased teeth. These were removed with penicillin being given prophylactically. The foci of infection for the pneumococcus meningitis were the right ear, pharynx, and tonsils. 4. Mention is made of the possibility of the meninges being made more susceptible to infection by the first attack.