TUBERCULOUS MENINGITIS OF ACUTE ONSET

Abstract

The classical descriptions of tuberculous meningitis all emphasize the insidious onset as one of the chief characteristics of the disease. Modern experience has amply confirmed this. For example, in a series of 55 young Servicemen treated at the Military Hospital for Head Injuries, Wheatley, and for whom a full history was obtained, 43 had been ill for over one week and 15 for over three weeks before admission to hospital (Taylor, 1954). At the same time, we have occasionally seen cases in which the onset, so far from being insidious, has been acute or even abrupt (Smith and Vollum, 1954; Case 1). As these cases have accumulated so we have come to recognize that they resemble each other in several respects besides the onset; in particular, early in the illness the cell counts in the cerebrospinal fluid (C.S.F.) are unusually high; the symptoms often