The introduction by Flexner, in 1907, of a curative serum for epidemic cerebrospinal meningitis has reduced the mortality under the most favorable conditions to a level now variously estimated at from 20 to 25 per cent. This relatively high death rate may be due to three factors: first, extreme virulence of the organism, producing a fulminating meningitis; second, an organism of different type from that used in preparing the antimeningococcus serum, and, third, late recognition of the disease. The latter is certainly the more common, since the fulminating type is rather rarely seen and the standard serums now on the market are polyvalent.
The routine administration of antimeningococcus serum by lumbar puncture has given gratifying results only in early cases. In late cases in which treatment was by lumbar puncture, the mortality has been very high, and in those patients who survive, hydrocephalus and other serious sequelae are comparatively common.
PEET MM. ADVANCED MENINGOCOCCUS MENINGITIS: TREATMENT BY COMBINED VENTRICULAR, CISTERNAL AND LUMBAR PUNCTURES. JAMA. 1926;86(24):1818–1821. doi:10.1001/jama.1926.02670500006003
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