THIS CASE of mixed meningitis due to Diplococcus pneumoniae and Klebsiella pneumoniae (Friedländer's bacillus) is reported because a search of the medical literature has failed to reveal a prior case of this combination.
Mixed meningitis of metastatic or hematogenous origin is apparently a rare condition, as there have been relatively few such cases reported in the literature. Cases of mixed meningitis in which the infection entered by direct extension from the middle ear, the mastoid or the paranasal sinuses or from cranial trauma have been reported more frequently. Even the latter cases have been few, however, when considered in relation to the thousands of cases of meningitis of all types that have been recorded. This is somewhat surprising: One would think that where the meninges are contaminated by direct extension a mixed infection would be the rule rather than the exception, but such is not the case. For instance, in
CONN JJ, ROSENOW OF. MIXED MENINGITIS: A Case of Combined Pneumococcus and Klebsiella Meningitis with Recovery. Arch Intern Med (Chic). 1950;85(6):924–932. doi:10.1001/archinte.1950.00230120033003
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