In 1917 I reported that out of 134 cases of pneumonia diagnosed by myself and colleagues in western Pennsylvania during the preceding eighteen months, there had been fourteen cases of pneumococcus meningitis, several of which, being Type I, were treated by the intravenous and intraspinal use of the antipneumococcus serum of the Rockefeller Institute, with very interesting results but without any recoveries.1 Since that time I have become more and more convinced that pneumococcus meningitis occurs much more frequently than has been supposed and far more frequently than it is recognized. Liebermeister has stated that in 25 per cent, of the cases of pneumonia there is a distinct suppurative inflammation in the membranes of the spinal cord, even though their gross appearance be unchanged.2
Evidence of meningeal irritation is often observed during the course of a pneumococcus infection, and these phenomena are too often treated as unimportant —as
LITCHFIELD L. PNEUMOCOCCUS MENINGITISTREATMENT BY A SPECIFIC ANTIPNEUMOCOCCUS SERUM. JAMA. 1919;72(19):1345–1348. doi:10.1001/jama.1919.02610190007003
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