The authors, basing on the own experience in the treatment of 578 patients with purulent meningitis and encephalitis, discuss etiologic and clinical problems as an early diagnosis of the cause decides on the proper therapy and often on the patient's fate. The authors are convinced that the result of general CSF examination is a crucial diagnostic criterion in meningitis and encephalitis but does not permit identification of the disease causes. Problems with etiological verification is discussed. The authors have found that the infection with N. meningitidis and S. pneumoniae remains the most frequent cause of the disease in adults. However, the cause of the disease cannot be determined in over 50% of patients, and etiological verification of infections caused by H. influenzae and anaerobic organisms is quite unsatisfactory. The authors stress that over 20% of patients had skull injury and meningitis most frequently resulted from the infection with S. pneumoniae in these patients. It is suggested that purulent meningitis and encephalitis as a rule is endogenous disease produced by the activation of endogenous source of the infection.

Adolescent↗

PubMedDate not supplied

[Methods and treatment results of purulent meningitis and encephalitis in adults--based on personal observations].

The authors present own methods and results of the treatment of 578 patients with suppurative meningitis and encephalitis. Etiologically most frequent infections due to N. meningitidis, S. pneumoniae, and H. influenzae were treated with penicillin and ampicillin; the authors recommend to replace the latter antibiotic with cefotaxime. If meningitis and encephalitis were due to aerobic gram-negative bacilli, a possibility of the simultaneous infection with anaerobic flora was considered, and the drugs active against both types of the organisms were administered. The same was the treatment in case of etiologically confirmed staphylococcal infection. In case of unknown etiology of meningitis and encephalitis therapy was based on clinical data, and laboratory findings.

Adult↗

PubMedDate not supplied

[C-reactive protein (CRP) and its significance in purulent meningitis].

CRP level was determined in the cerebrospinal fluid in 40 cases of bacterial meningitis. Similar determination in serum was done in 32 of these patients. Aetiological verification was possible in 90% of cases. Meningitis caused by Str. pneumonia and Neisseria meningitides prevailed (52.5% and 27.5% respectively). The control group comprised 20 subjects. For CRP demonstration immunochemical and turbidimetric methods were used. CRP in CSF was raised in 62.5% of the study cases while in the serum it was raised in all of them. CRP detection in serum in acute phase of central nervous system infection is diagnostically important since CRP increase suggests a purulent process.

Adolescent↗