Meningitis Due to Bact. Enteritidis

MENINGITIS due to organisms of the typhoid-salmonella group is comparatively rare. 'T'he case presently recorded was caused(by bact. enteritidis (Gaertner), and several examples of similar origin have been culled from the literature. R. M., a male infant aged 21 months, the second child of healthy parents. The father was a milk vendor, and the child livedl witlh its parents on a dairy farm just outsi(le the city boundary. The child was fed on a raw milk mixture, on which he appeared to thrive. Fifteen days before the illness he was vaccinated, and from that time the mother noticedl the childl becoming "fretful and feverish." He continued to feed well, although he vomited occasionally. Nothing unusual was notice(l in the type or frequenc) of the motions. He became drowsy, and ceased vomiting three day,s before adlmission to hospital. On admission to the war(l of the late Dr. Malcolm Brice Smyth, the infant had a temperature of 102°, an(d the pulse was 160. Nutrition and development were good. 'lThere was a small dry vaccination crust on the left arm. The child was drowsy, but fed well, and(cried on handlinig. Head retraction and neck rigidity were present, an(l the anterior fontanelle was tense. Spasmodic twitching of the muscles of the face and arms was observed. The left pupil was insensitive to light, and both optic discs showed (lefinite choking. Cisterni puncture yielded 10 c.c. flui(d undler increased pressure. Next day the drowsiness had (leepened to coma, andl feedinlg became difficult. 15 c.c. cerebro-spinal flui(d was withdrawn by lumbar puncture. 'Two normal motions were passed. On thie third (lay, several convulsions occurred ;coma deepened. Cistern puncture was repeated, without abatement of the meningitic con(dition. 'I'he child died suddenly on the thir((lay after admission. Post-mortem examination was not obtained. All three specimens of cerebro-spinal fluid showed marke(d turbidity and opal-escence. On standing, thev vielded a heavy deposit, but no clot. The cell counts rangedi from 350 to 520 cmm., polymorphonuclears predominating. The third specimen contained 5(;0 mg. per cent. chlorides, and only a trace of glucose. Direct examinationi in each case showed the presence of motile gram negative bacteria in large numbers. On culture, the organism gave the biochemical reactions of the salmonella group. Dr. XVk. F. Green very kindlly didl the following agglutina-tions, which were all negative Organism with bact. typhosum, bact. paratyphosum A and B, and patient's sera. By the good offices of …