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February 10, 1984

Sulfonamides and Meningitis

Author Affiliations

From the Departments of Internal Medicine (Infectious Diseases) (Drs Scheld and Mandell) and Neurosurgery (Dr Scheld), University of Virginia School of Medicine, Charlottesville.

JAMA. 1984;251(6):791-794. doi:10.1001/jama.1984.03340300083036

The article reprinted in this issue of The Journal1 was recognized as a landmark study even at the time of its publication in 1937. Schwentker and colleagues reported their preliminary observations on the treatment of 11 patients with invasive meningococcal disease with a new compound, sulfanilamide. The results achieved (ten of 11 survived; 91% survival) were far superior to those obtained with the then-conventional antimeningococcal antisera therapy (survival, 15% to 70%, dependent on age). In addition, there were fewer adverse side effects with sulfanilamide; horse serum injections could be avoided. As a result, sulfonamides became the mainstay of therapy for serious meningococcal disease for more than three decades.

Presulfonamide Treatment of Meningococcal Meningitis  "Epidemic cerebrospinal fever" (meningococcal meningitis) was described in detail by Gaspard Vieusseux after an outbreak in Geneva in the spring of 1805. The etiologic agent was first isolated from purulent CSF by Weichselbaum in 1887. At