Skip to main content
The Journal of Hygiene logoLink to The Journal of Hygiene
. 1982 Jun;88(3):383–401. doi: 10.1017/s002217240007025x

Bacterial meningitis--ten years experience.

P G Davey, J K Cruikshank, I C McManus, B Mahood, M H Snow, A M Geddes
PMCID: PMC2134113  PMID: 7086113

Abstract

Between January 1968 and December 1977, 635 cases of acute bacterial meningitis were admitted to hospitals in the Birmingham Area Health Authority. The epidemiology of these cases was analysed and compared with the 270 cases which were admitted to the regional infectious diseases unit at East Birmingham Hospital (E.B.H.). In children and young adults the meningococcus was the commonest causative organism while over the age of 25 pneumococcal meningitis predominated. Although Haemophilus influenzae was the second commonest infecting organism it was a rare cause of meningitis in school children and adults, only four cases presenting in these age groups in the Birmingham Area. A detailed analysis was made of the symptoms, signs, laboratory investigations and clinical course of the 270 cases treated at E.B.H. The mortality in the patients with pneumococcal meningitis was 30%. In the meningococcal group it was 3.5% and in the haemophilus groups 7.7%. An analysis of the various treatment regimes employed in the 270 E.B.H. patients supports the view that a single antibiotic is sufficient for the therapy of most forms of bacterial meningitis. Intrathecal antibiotic administration is unnecessary in pyogenic meningitis caused by meningococci, pneumococci or H. influenzae.

Full text

PDF
383

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baird D. R., Whittle H. C., Greenwood B. M. Mortality from pneumococcal meningitis. Lancet. 1976 Dec 18;2(7999):1344–1346. doi: 10.1016/s0140-6736(76)91985-1. [DOI] [PubMed] [Google Scholar]
  2. CARPENTER R. R., PETERSDORF R. G. The clinical spectrum of bacterial meningitis. Am J Med. 1962 Aug;33:262–275. doi: 10.1016/0002-9343(62)90024-4. [DOI] [PubMed] [Google Scholar]
  3. DODGE P. R., SWARTZ M. N. BACTERIAL MENINGITIS--A REVIEW OF SELECTED ASPECTS. II. SPECIAL NEUROLOGIC PROBLEMS, POSTMENINGITIC COMPLICATIONS AND CLINICOPATHOLOGICAL CORRELATIONS. N Engl J Med. 1965 May 13;272:1003–CONCL. doi: 10.1056/NEJM196505132721906. [DOI] [PubMed] [Google Scholar]
  4. Davey P. G., Cruckshank J. K. Secondary spread of H. influenzae. N Engl J Med. 1979 Dec 27;301(26):1448–1448. doi: 10.1056/NEJM197912273012614. [DOI] [PubMed] [Google Scholar]
  5. Davey P. G., Geddes A. M., Cruickshank A. J. Chemoprophylaxis for contacts of Haemophilus influenzae meningitis. Br Med J. 1980 May 24;280(6226):1272–1272. doi: 10.1136/bmj.280.6226.1272-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. EIGLER J. O., WELLMAN W. E., ROOKE E. D., KEITH H. M., SVIEN H. J. Bacterial meningits. I. General review (294 cases). Proc Staff Meet Mayo Clin. 1961 Jul 19;36:357–365. [PubMed] [Google Scholar]
  7. Easton D. M., Estcourt P. G., Brimblecombe F. S., Burgess W., Hass L., Kurtz J. B. Outbreak of meningococcal disease in Devon. Br Med J. 1974 Mar 16;1(5906):507–509. doi: 10.1136/bmj.1.5906.507. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Emmerson A. M. The need for a pneumococcal vaccine. J Antimicrob Chemother. 1980 May;6(3):301–302. doi: 10.1093/jac/6.3.301. [DOI] [PubMed] [Google Scholar]
  9. Eykyn S. J., Thomas R. D., Phillips I. Haemophilus influenzae meningitis in adults. Br Med J. 1974 Jun 1;2(5917):463–465. doi: 10.1136/bmj.2.5917.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Feigin R. D., Stechenberg B. W., Chang M. J., Dunkle L. M., Wong M. L., Palkes H., Dodge P. R., Davis H. Prospective evaluation of treatment of Hemophilus influenzae meningitis. J Pediatr. 1976 Apr;88(4 Pt 1):542–548. doi: 10.1016/s0022-3476(76)80002-9. [DOI] [PubMed] [Google Scholar]
  11. Finland M., Barnes M. W. Acute bacterial meningitis at Boston City Hospital during 12 selected years, 1935-1972. J Infect Dis. 1977 Sep;136(3):400–415. doi: 10.1093/infdis/136.3.400. [DOI] [PubMed] [Google Scholar]
  12. Foster M. T., Jr, Sanders E., Ginter M. Epidemiology of sulfonamide-resistant meningococcal infections in a civilian population. Am J Epidemiol. 1971 May;93(5):346–353. doi: 10.1093/oxfordjournals.aje.a121267. [DOI] [PubMed] [Google Scholar]
  13. Fraser D. W., Henke C. E., Feldman R. A. Changing patterns of bacterial meningitis in Olmsted County, Minnesota, 1935-1970. J Infect Dis. 1973 Sep;128(3):300–307. doi: 10.1093/infdis/128.3.300. [DOI] [PubMed] [Google Scholar]
  14. GOSSAGE J. D. ACUTE PURULENT MENINGITIS IN CHILDREN: EXPERIENCE AT THE HOSPITAL FOR SICK CHILDREN, TORONTO. Can Med Assoc J. 1964 Mar 7;90:615–617. [PMC free article] [PubMed] [Google Scholar]
  15. Glode M. P., Daum R. S., Goldmann D. A., Leclair J., Smith A. Haemophilus influenzae type B meningitis: a contagious disease of children. Br Med J. 1980 Mar 29;280(6218):899–901. doi: 10.1136/bmj.280.6218.899. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Goldacre M. J. Acute bacterial meningitis in childhood. Incidence and mortality in a defined population. Lancet. 1976 Jan 3;1(7949):28–31. doi: 10.1016/s0140-6736(76)92921-4. [DOI] [PubMed] [Google Scholar]
  17. Goldacre M. J., Miller D. L. Completeness of statutory notification for acute bacterial meningitis. Br Med J. 1976 Aug 28;2(6034):501–503. doi: 10.1136/bmj.2.6034.501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. HAGGERTY R. J., ZIAI M. ACUTE BACTERIAL MENINGITIS. Adv Pediatr. 1964;13:129–181. [PubMed] [Google Scholar]
  19. Haeney M. R., Thompson R. A., Faulkner J., Mackintosh P., Ball A. P. Recurrent bacterial meningitis in patients with genetic defects of terminal complement components. Clin Exp Immunol. 1980 Apr;40(1):16–24. [PMC free article] [PubMed] [Google Scholar]
  20. Hodges G. R., Perkins R. L. Acute bacterial meningitis: an analysis of factors influencing prognosis. Am J Med Sci. 1975 Nov-Dec;270(3):427–440. doi: 10.1097/00000441-197511000-00003. [DOI] [PubMed] [Google Scholar]
  21. JAWETZ E., GUNNISON J. B. An experimental basis of combined antibiotic action. J Am Med Assoc. 1952 Oct 18;150(7):693–695. doi: 10.1001/jama.1952.63680070011015. [DOI] [PubMed] [Google Scholar]
  22. Jensen K., Ranek L., Rosdahl N. Bacterial meningitis; a review of 356 cases with special reference to corticosteroid and antiserum treatment. Scand J Infect Dis. 1969 May;1(1):21–30. doi: 10.3109/inf.1969.1.issue-1.04. [DOI] [PubMed] [Google Scholar]
  23. Jonsson M., Alvin A. A 12-year review of acute bacterial meningitis in Stockholm. Scand J Infect Dis. 1971;3(2):141–150. doi: 10.3109/inf.1971.3.issue-2.08. [DOI] [PubMed] [Google Scholar]
  24. KNEEBONE G. M. Purulent meningitis in childhood. Med J Aust. 1961 Jul 22;48(2):124–130. doi: 10.5694/j.1326-5377.1961.tb24352.x. [DOI] [PubMed] [Google Scholar]
  25. Lambert H. P. Use of antibiotics. Meningitis. Br Med J. 1978 Jul 22;2(6132):259–261. doi: 10.1136/bmj.2.6132.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Laxer R. M., Marks M. I. Pneumococcal meningitis in children. Am J Dis Child. 1977 Aug;131(8):850–853. doi: 10.1001/archpedi.1977.02120210028004. [DOI] [PubMed] [Google Scholar]
  27. Letter: Meningococcal disease. Br Med J. 1974 May 4;2(5913):272–272. doi: 10.1136/bmj.2.5913.272. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Lindberg J., Rosenhall U., Nylén O., Ringnér A. Long-term outcome of Hemophilus influenzae meningitis related to antiobiotic treatment. Pediatrics. 1977 Jul;60(1):1–6. [PubMed] [Google Scholar]
  29. Mackenzie A. M. Combined action of chloramphenicol and ampicillin on Haemophilus influenzae. J Antimicrob Chemother. 1979 Nov;5(6):693–698. doi: 10.1093/jac/5.6.693. [DOI] [PubMed] [Google Scholar]
  30. Mandal B. K. The dilemma of partially treated bacterial meningitis. Scand J Infect Dis. 1976;8(3):185–188. doi: 10.3109/inf.1976.8.issue-3.12. [DOI] [PubMed] [Google Scholar]
  31. Massanari R. M. Purulent meningitis in the elderly: when to suspect an unusual pathogen. Geriatrics. 1977 Mar;32(3):55–59. [PubMed] [Google Scholar]
  32. Mathies A. W., Jr, Leedom J. M., Ivler D., Wehrle P. F., Portnoy B. Antibiotic antagonism in bacterial meningitis. Antimicrob Agents Chemother (Bethesda) 1967;7:218–224. [PubMed] [Google Scholar]
  33. QUAADE F., KRISTENSEN K. P. Purulent meningitis. A review of 658 cases. Acta Med Scand. 1962 May;171:543–550. [PubMed] [Google Scholar]
  34. Rahal J. J., Jr Antibiotic combinations: the clinical relevance of synergy and antagonism. Medicine (Baltimore) 1978 Mar;57(2):179–195. [PubMed] [Google Scholar]
  35. Richter R. W., Brust J. C. Pneumococcal meningitis at Harlem hospital. N Y State J Med. 1971 Dec 1;71(23):2747–2754. [PubMed] [Google Scholar]
  36. Sell S. H., Merrill R. E., Doyne E. O., Zimsky E. P., Jr Long-term sequelae of Hemophilus influenzae meningitis. Pediatrics. 1972 Feb;49(2):206–211. [PubMed] [Google Scholar]
  37. Tomasz A., Waks S. Mechanism of action of penicillin: triggering of the pneumococcal autolytic enzyme by inhibitors of cell wall synthesis. Proc Natl Acad Sci U S A. 1975 Oct;72(10):4162–4166. doi: 10.1073/pnas.72.10.4162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Tugwell P., Greenwood B. M., Warrell D. A. Pneumococcal meningitis: a clinical and laboratory study. Q J Med. 1976 Oct;45(180):583–601. [PubMed] [Google Scholar]
  39. Ward J. I., Fraser D. W., Baraff L. J., Plikaytis B. D. Haemophilus influenzae meningitis. A national study of secondary spread in household contacts. N Engl J Med. 1979 Jul 19;301(3):122–126. doi: 10.1056/NEJM197907193010302. [DOI] [PubMed] [Google Scholar]
  40. Weiss W., Figueroa W., Shapiro W. H., Flippin H. F. Prognostic factors in pneumococcal meningitis. Arch Intern Med. 1967 Nov;120(5):517–524. [PubMed] [Google Scholar]

Articles from The Journal of Hygiene are provided here courtesy of Cambridge University Press

RESOURCES