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60
EPIDEMIC CEREBROSPINAL MENINGITIS.
Five notifications of cases supposed to be suffering from Epidemic Cerebrospinal
Meningitis were received during 1913.
Of these two were found on post-mortem examination in the North-Western
Hospital (M.A.B.) to have suffered from tuberculous meningitis and not meningitis
due to the meningococcus.
There were therefore only three cases in which the diagnosis was not revised.
No connection was traced between these cases, details of which are given
being:-
W. G. G. Male, aged 16. Notified 20th March, 1913, District North 2, in Ward 1:—
Onset 19th March, when he returned from school with headache, earache and
glands slightly swollen under ear. Vomiting and delirium later. No
record of any rash. Removed to North-western Hospital (M.A.B.) on
20th March, and died 21st March. No bacteriological examination.
Post-mortem examination showed inflammation of meninges of brain and
cord, with much lymph and an excess of cloudy spinal fluid.
E. K. Male, aged 19. Notified 16th April, 1913, District West 4, in Ward 5:—
Onset sudden on 12th April. Headache, vomiting, muttering delirium, head
retraction, tache cerebrate, Kernig's sign. No rash except herpes labialis
on day of onset. Removed to Middlesex Hospital on 16th April. No
organism identified from nose. Two lumbar punctures, but no fluid
withdrawn. Complete recovery. There was said to be no reason for
revising diagnosis.
E. B. Female, aged 1. Notified 25th April, 1913, District West 5, in Ward 5:—
Onset 15th February, began with diarrhoea and later vomiting. Head retraction
and Kernig's sign by 21st February. Muscular rigidity well marked by
3rd March. Slight erythema over face, abdomen and limbs. No record
of petechial rash. Removed to University College Hospital. Died on 3rd
May from broncho-pneumonia and inanition. Gram-negative diplococcus
found, grown in hæmoglobin-agar (Nasgar medium not tried). Result of
post-mortem examination:— old thickening of membranes round the cerebellum
and inter-peduncular space; no recent exudate.
No source of infection was traced in any case, nor any connection between
the cases.