Nervous Infections during Epidemic of Influenza B

Abstract

TREATMENT OF H. INFLUENZAE MENINGITIS BRMTISCL be overcome by introduction of air and heparin into the cerebrospinal canal, and it may be worth while to try her methods in such desperate cases.It need not be feared that children thus saved might prove to be crippled in one way or another for the rest of their lives.Regarding such consequences Alexander (private communication) states:" The experience in this country when both sulphadiaziiie and type-specific rabbit antiserum are used in combination for the treat- ment of influenzal meningitis indicates that any residual damage to the brain is exceedingly rare following recovery.This appears to be true even in very chronic cases of the disease which recover over a long period of time.For example, I know, as a result of my own experience and by talking over the experiences of a number of others, of only one case in which residual damage to the brain followed a child's recovery."In all, 5 out of 20 cases were treated with sulphonamides alone.Only one of these five recovered.Fifteen cases had combined sulphonamide-penicillin treatment and eight of them recovered.The total number of cases is too small and the methods of treatment varied too much to allow of statistical assessment.The only conclusion to be drawn is that the encouraging recovery rate suggests pushing to the limit the combined sulphonamide-peaicillin treatment, perhaps supported by specific antiserum.The sporadic occurrence of H. influenzae meningitis in this country makes it very difficult for any investigator, singlehanded, to work out a satisfactory routine treatment.It seems reasonable to suggest that cases of H. influenzae meningitis of the non-fulminant type should be concentrated in a number of treatment centres.An adequate method of treatment, as in the case of subacute bacterial endocarditis, might be evolved for the majority of cases, and a substantial number of children's lives might thus be saved.Summary A survey of the various methods of treating H. inifluenzae meningitis is presented.Clinical data are given of 19 cases of H. influenzae type b meningitis and of 1 case due to H. influenzae of the respiratory group.Of 5 cases treated only with sulphonamides, one recovered.Fifteen cases had combined sulphonamide-penicillin. treatment.Eight of these recovered.It is suggested that the combined administration of these drugs should be used more energetically in H. influenzae meningitis.In view of the good therapeutic results reported from the U.S.A. specific H. inifiutenzae type b rabbit anti- serum, which is now available in this country, should also be given.The establishment of a number of treatment centres to evolve a standard routine method of treatment is advocated.