HEMOPHILUS INFLUENZAE MENINGITIS

The results obtained in the treatment of 110 infants and children with H. influenzae meningitis are presented and the various agents used in the therapy of the disease are evaluated. Eighty-seven (79%) survived. Sixty-eight (62%) recovered completely. Eight of the 23 deaths occurred within the first 24 hours after hospital admission. Slightly over one half the children were less than one year of age. Only 69% of this group survived as compared with 90% in the group over one year of age; only 50% of the younger group recovered completely as compared with 75% of the older group. The plan of therapy underwent various modifications and additions during the eight year period covered in this study. Forty-four per cent of the patients were treated with specific H. influenzae rabbit antiserum and sulfadiazine; 48% were treated with these agents together with streptomycin (and in many instances penicillin). The remaining 8% were treated with streptomycin alone or in combination with sulfadiazine. The survival and complete recovery rates of those treated with serum, sulfadiazine and streptomycin were not significantly different from the rates of those treated with serum and sulfadiazine alone. The number of patients treated with streptomycin without serum was too few for analysis. Specific antiserum used early and in large doses seemed to be a valuable therapeutic agent in these studies. It is believed that this antiserum should be used in the treatment of all patients except perhaps older children and younger children who are only mildly ill. The high cost of this serum, however, remains a major problem. Streptomycin undoubtedly is a valuable therapeutic agent in the disease; in this study, however, there has been no striking improvement in the over-all results since its introduction. Sulfonamides and especially sulfadiazine appear to have been of limited but definite value in the treatment of this disease and their continued use in all patients is recommended. Penicillin when given in high dosages would also seem to be a helpful therapeutic adjunct when used along with other agents. Follow-up data on 64 of the 87 surviving patients are presented.