The introduction of antimicrobial agents has converted bacterial meninitis from a disease that was almost always fatal to one in which the majority of patients survive without significant neurologic residua. However, since then, there have been no outstanding changes in the mortality rate of purulent meningitis.
Based on the bacteriological and clinical data observed from May 1972 to July 1981 at the Hanyang University Hospital, the following findings were obtained. (The unusual organisms defined as those other than S. pneumoniae, H. influenzae and N. :meningitidis.)
<1> The average annual incidence per 1, 000 admissions was approximately 0. 5.
<2> Of 1, 342 cerebrospinal fluid specimens submitted, 83 cases were positive for cultures, and the positive rate was 6. 2%.
<3> About sixty four percent of isolated organisms were S. pneumoniae, H. influenzae, and N. meningitidis. Others were Gram negative bacilli in 21.7% and Gram positive cocci in 9.6/. There were three cases of C. neoformans and one case of C. albicans was also isolated.
<4> The positive rate of culture in unusual organisms was slightly increased since 1979.
<5>Nearly one-fourth of the cases could be considered as hospital acquired infec-, tion and majority(78. 9%) of them occurred, in the adult and elderly age groups. Thirty percent of pneumococcal meningitis and 44. 4 0 of meningitis due to Gram negative bacilli were hospital acquired infections.
<6> Male to female ratio of menngitis was approximately 2 : 1 and the male preponderance was observed especially, in H. influenzae and S. pneumoniae infections.
<7>Approximately ten percent of the cases occurred under I month of age, 45 before I year of age, 60 flo before 5 years and 72% before 15 years of age.
<8 >H. influenzae was isolated only between 3 months and 15 months of age.
<9>The incidence of purulent meningitis was highest in winter. This was especially true for those. due to S. pneumoniae and H. influenzae.
<10> Most of the predisposing factors were respiratory infections, head. trauma and recent neurosurgical procedures.
<11>The protein content of CSF was highest in the meningitis due to S. pneumoniae. Leukocyte count was most increased in N. meningitidis.
<12>Serum sodium cencentrations were below 130mEq/L at the time of admission in half of the patients.
<13>Bacteremia was demonstrable in about half of patients with purulent meningitis.
<14>Most of the strians of H. influenzae were resistant to ampicillin.
<15>Mortality rate for purulent meningitis was approximatly 300/0 and the mortality from H. influenzae meningitis was highest in which the rate was about 50%. There was. no fatal case in meningococcal meningitis. Both extreme age groups revealed the highest mortality rate.
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