I believe it may be stated without fear of contradiction that the most dreaded complications of infections of the ear, mastoid and nasal accessory sinuses, are acute suppurative pneumococcus, streptococcus and staphylococcus meningitis. This is true because of the extremely high mortality with ordinary and present-day methods of treatment, consisting of spinal punctures and the intraspinal injection of immune serums. During the past seven years, I have seen four cases of acute purulent streptococcus and forty-one of pneumococcus meningitis of otitic or nasal origin, or following fractures of the base of skull, in all of which the patients died. It may be that streptococcus meningitis occasionally develops without a primary focus of infection in the upper respiratory tract, or without a preceding fracture of the skull opening up a pathway for infection of the meninges, but I have not seen any cases of this kind. It is true, however, that
KOLMER JA. THE CHEMOTHERAPY AND SERUM THERAPY OF PNEUMOCOCCUS AND STREPTOCOCCUS MENINGITIS: I. A RÉSUMÉ OF THE PRESENT STATUS OF THE TREATMENT OF SEPTIC MENINGITIS, WITH THE RECOMMENDATION OF A METHOD. Arch Otolaryngol. 1926;3(6):481–513. doi:10.1001/archotol.1926.00580010515001
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