Influenzal Meningitis

OUR attention recently has been attracted by the occurrence in Purdvsburn Fever Hospital of several cases of mneningitis in which the causal organism was the hzinophilits influienzcw. A study of all admissions to Purdysburn Fever Hospital since its opening in November, 1906, shows that the first case (liagnosed as influenzal meningitis was adlmitted inl October, 1929. Another case followe(d in February, 1930, and then none occurre(d until August, 1936. A fourth case was diagnosed in November, 1936, and the occurrence of three cases during October, 1937, seems to justify a report upon these cases-seven in all. 1929, otn the eighth day of illness. Onset had been gradual, with fretfulness and vomiting. There was no previous history of illness. On admission: fretful and irritable; faint erythema of trunk and limbs, slight tache cerebrale; slight rigidity of neck, with Kernig's sign doubtful; no obvious paralysis; heart, lungs, and abdomen-nothing abnormal detected. 'T'emperature 99.4, pulse 136. A lumbar puncture gave 40 c.c. of turbid fluid containing polymorphonuclears +, and h. influenze direct and on culture. 'l'wenty c.c. meningococcal serum was given intra-thecally on the appearance of the cerebro-spinal fluid. Next day lumbar puncture 50 c.c. similar fluid, polymorphonuclears + +, h. influenzw + +, and onl culture. Fluid was again replaced by 20 c.c. meningococcal serum. Lumbar puncture was repeated on tenth and eleventh days with similar findings. Course: Remittent temperature up to 103, pulse up to 200; semiconscious and irritable; drinking well, no vomiting; squint developed; rigidity and retraction markedl. Death at seventeenth (lay of illness.