April 12, 1965

Toxicity of Intrathecally Administered Pancreatic Dornase

Author Affiliations

From the departments of internal medicine and pediatrics, University of Utah College of Medicine (Drs. Parker and Wilcox), and the Salt Lake County General Hospital, Salt Lake City (Dr. Dietrich). Dr. Dietrich is now at the Good Samaritan Hospital, Portland, Ore.

JAMA. 1965;192(2):169-171. doi:10.1001/jama.1965.03080150099032

DEATH AND MORBIDITY from pyogenic meningitis have been dramatically reduced since the discovery of antimicrobial agents. Yet, 5% to 25% of patients with this disease die, and 5% to 25% who survive have neurological complications, in spite of seemingly appropriate antimicrobial therapy.1 Since these fatalities and complications may be related to the presence of extensive inflammatory exudate over the meninges, enzymatic debridement has been suggested as an adjunct to therapy.2 Virtual absence of antigenicity distinguishes pancreatic dornase from deoxyribonuclease (DNA-ase) produced by streptococci. Thus, pancreatic dornase was selected for intrathecal injection, as a means of liquefying the exudate from pyogenic meningitis. In the few reported cases, there has been no mention of toxicity from the intrathecal administration of pancreatic dornase.2,3

This case is reported because fever, nuchal rigidity, and elevated cerebrospinal-fluid-protein levels occurred after the intrathecal injection of pancreatic dornase. Reporting of this single case is further

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