Lewis K. Sweet

Meningitis in infants and children with special reference to age-incidence and bacteriologic diagnosis

Summary 1. The susceptibility of infants to infection is apparent from the age distribution of the various etiologic types of meningitis. The majority of cases of each type occur during the first two years of life. 2. The frequency of the occurrence of influenzal meningitis is pointed out. 3. The characteristics of the spinal fluid are discussed for the various types of meningitis from the point of view of practical etiologic diagnosis. 4. The superiority of chocolate agar as a routine spinal fluid culture medium is emphasized. 5. Summaries of nine cases of meningitis due to various members of the colon group of bacilli are presented. In addition one case due to the Friedlander bacillus is presented.

Amebic abscess of the liver

Summary A case of amebic abscess of the liver occurring in a Chinese girl, aged five years, is reported. Aspiration of the abscess combined with subcutaneous injection of emetine hydrochloride, the treatment of choice for such a patient, was followed by apparent cure.

Congenital malformation of the bile ducts

Summary Three cases of congenital malformation of the bile ducts with complete atresia, occurring in a single family are reported with brief operative notes on two and necropsy findings on all. Six similar cases with familial incidence of the anomaly are listed from the literature.

Acute lymphocytic choriomeningitis

Summary 1. Twenty-one patients with lymphocytic choriomeningitis are presented.The clinical and laboratory features of the disease are discussed in detail. 2. The differential diagnosis is outlined and the point is emphasized that only a presumptive diagnosis is possible on clinical grounds in this disease, the final proof being the isolation of the virus from the patients blood or spinal fluid, or the demonstration of an increasing titer of antibody in the patients blood following the acute illness.

Multiple cystic tuberculosis of the long bones

Summary A case of multiple cystic tuberculosis of the long bones in a 3-year-old child is reported. It is suggested that this condition and Junglings Osteitis tuberculosa multiplex cystoides are separate entities. Differential criteria are outlined.

Acute serous meningitis in scarlet fever

Summary We have reported eleven cases of acute serous meningitis occurring within from five to eight days after the onset of scarlet fever. The disease is characterized by fever, meningeal irritation, prostration, and toxemia. The spinal fluid shows a pleocytosis of from 32 to 1,100 cells, almost all lymphocytes, increased protein, and normal sugar. Following lumbar puncture the symptoms subside. No sequelae to the disease have been encountered.

Gonococcal conjunctivitis in children

Summary The results of treatment of sixty-two patients with gonorrheal conjunctivitisare reviewed. Of thirty patients who received sulfanilamide, 24 showed rapid recovery. Thirty-three patients, including four who failed to respond to sulfanilamide, received sulfapyridine. A rapid recovery was experienced by thirty-one. Three patients were treated with sulfathiazole; all responded promptly. Only one corneal ulcer developed, this being in a patient on sulfanilamide therapy. Reports on over forty-five cases of gonorrheal conjunctivitis treated with sulfapyridine have been collected from the literature. The results in these cases were comparable to those in the current series.

Mongoloid imbecility in the mongolian races

Summary The case histories of two Chinese children with mongoloid imbecility are presented in detail. Three similar children, one a Eurasian, are mentioned. A brief resume of the literature of this condition in mongolian races is made. With the publication of this report there are six definite instances of mongolism in Chinese and sixty or more in Japanese patients recorded in the literature.

The use of normal serum gamma globulin antibodies (human) concentrated (immune serum globulin) in the prevention and attenuation of measles.

Summary Gamma globulin was given to 267 exposed susceptible children in an effortto attenuate or prevent measles. Final results have been obtained for 241 children. Of these, fifty developed mild or attenuated measles and seven developed average measles. Among sixteen children who were re-exposed six to twenty-eight days after injection, the original treatment gave full protection to thirteen while three developed very mild measles. Only one child developed a complication (acute otitis media). There were no significant reactions to the injections of gamma globulin.