Margaret H. D. Smith

Tuberculous meningitis in children during the isoniazid era.

Fifty-nine cases of tuberculous meningitis in children seen at the Charity Hospital at New Orleans since the addition of isoniazid to the therapy in 1952 are reviewed. Fourteen of the children died during hopsitalization. At discharge 21 children had complete or nearly complete clinical recovery. Follow-up of 21 available long-term survivors revealed a significant number with neurologic and social disabilities. The endemicity of tuberculous infections in the households of the children and factors responsible for transmission of tubercle bacilli from an adult source are reported. The importance of chemoprophylaxis and public health measures in eliminating this disease are stressed.

Streptomycin in the treatment of influenzal meningitis

Summary 1. Streptomycin is effective against H. influenzae type B in vivo as well as in vitro. 2. Eight patients with meningitis due to this organism were treated. Four recovered, three died, and in one, therapy was given up in favor of sulfonamide and serum. 3. Death in one case was associated with the appearance of drug fastness. 4. Toxic reactions encountered include: erythema, urticaria, augmentation of meningeal signs, persistence of pleocytosis, local pain on injection, and mild shock on initial administration. None of these was serious. 5. Streptomycin is worthy of further clinical trial in cases of infections due to H. influenzae type B, and also in cases of meningitis due to bacterial agents which are sensitive to this drug.