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KMID : 0367419700110020025
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Journal of Korean Pediatric Society
1970 Volume.11 No. 2 p.25 ~ p.29
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Recurrent Pneumococcal Meningitis
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金錫圭/Kim, Suk Kyu
李承旭/申東鶴/金潗/Lee, Seung Wook/Shin, Dong Hak/Kim, Jip
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Abstract
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A case of pneumococcal meningitis which showed five times of recurrence was observed.
Although several authers reported that the underlying factor of recurrent pneumococcal meningitis is to be defect of the skull or dura, there, at this case, was a large opening about lmm. in diameter at tegmen tympani, which was found at the fifth hospital admission.
It has clinically shown that about half of recurrent cases, the causes have been unknown. It is difficult to find out the cause. In bacteriological diagnosis, the culture of CSF is the factor of the bacteriological diagnosis. In blood culture 50% turned out to be positive but bacterial culture in the upper respiratory tract doesn´t help in making a diagnosis.
About half of recurrent pneumococcal meningitis has been seen in infant and children. The mortality rate of infant and children is lower than adult, but thesequela is more frequent and severe.
For the treatment removeing of underlying factor is important. Penicillin is drug of choice. Keco mmenued treatment is to use both penicillin and sulfonamide for at least 2-3 weeks. It is better to avoid using penicillin and chloramphenicol together. Corticosteroid hormone doesn´t affect on the mortality rate, but has been proved to be effective in preventing sequels.
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