Writers on epidemic cerebrospinal meningitis speak of the heart complications of the fatal but fortunately rare endocarditis and the rarer still myocarditis. The pericardium is passed over with silence. Winslow and Shipley1 studied sixty-two cases of purulent pericarditis bacteriologically; they have found chiefly pneumococci, streptococci and staphylococci, occasionally B. pyocyaneus and B. perfringens. No mention is made of meningococci, yet Herrick2 found 12 cases of meningococcic pericarditis in 280 cases of epidemic cerebrospinal meningitis, an incidence of 4.9 per cent. With only one exception the meningococcic pericarditis occurred in very severe cases; and while the mortality of the entire epidemic was 24.8 per cent. the mortality of the cases with the pericarditic complication reached 83.5 per cent. Only two cases of the meningococcic pericarditis were recognized clinically.2
Purulent pericarditis, whether resulting from a hematogenous metastatic spread, mere contiguity or direct trauma, is always a most serious complication
Trace IM, Berkovitz C. MENINGOCOCCIC PURULENT PERICARDITIS COMPLICATING EPIDEMIC CEREBROSPINAL MENINGITISRECOVERY AFTER TREATMENT WITH INTRAPERICARDIAL INJECTIONS OF ANTIMENINGOCOCCUS SERUM. JAMA. 1931;97(4):246–247. doi:10.1001/jama.1931.27310040002010a
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