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113
Hospital. The case was ultimately diagnosed as Tubercular Meningitis
and the notes from the Hospital are as follows:—
On admission was sleepy but quite intelligent, and there were
no abnormal physical signs. Examination of the cerebro spinal
fluid showed numerous lymphocytes. Protein .36 per cent. instead
of a normal .02 per cent. No sugar. Showing general character
of cerebro spinal fluid in tuberculous meningitis. Tubercle bacilli
were not found in the sputum. A cultivation from the faeces
gave a mixed growth of bacillus coli communis and enterococcus.
An examination of the urine showed triple phosphate crystals only.
No micro-organisms were detected. The cultivation gave streptococcus
brevis and no non-lactose fermentors were detected. A
diagnosis of tuberculous meningitis was made.
On September 30th there was a sudden change for the worse
and the child became unconscious, and the temperature went up to
105 degrees.
The child died on October 1st.
The notes of the post mortem examination are given below : —
Brain.—Soft, and the meninges in the interpeduncular
thickened. There were numerous small tubercles to be seen along
the course of the middle cerebral arteries. The lateral ventricles
were slightly distended.
Bronchial Glands.—Thickened.
Lungs.—Showed numerous miliary tubercles in all lobes and
a fibrinous pleurisy.
Mesenteric Glands.—Caseous.
Ileum.—Showed several small tubercles.
Case No. 39.
M. 15. Onset 13/12/24.
Initial symptom was intense headache No sore throat. He
was admitted to the Isolation Hospital the condition on admission